Effects of Computer-based Stress Management Training on Psychological Well-being and Work Performance in Japanese Employees: A Cluster Randomized Controlled Trial

This study evaluated the effectiveness of a computer-based stress management training (SMT) program in improving employees’ psychological well-being and work performance. A total of 12 work units (N=263) were randomly assigned to either an intervention group (8 work units, n=142) or to a wait-list control group (4 work units, n=121). All participants were requested to answer online questionnaires assessing psychological well-being as a primary outcome, and coping style, social support, and knowledge about stress management as secondary outcomes at baseline (T0), immediately after the intervention (T1), and 2 months after the intervention (T2). The group × time interaction was tested using a mixed-model repeated measures ANOVA. Results showed a group × time interaction for “knowledge about stress management” in the entire sample. Among participants who had more than 3 d of training, a significant group × time interaction was observed for “problem-solving” and “avoidance and suppression” as well as “knowledge about stress management.” Our computer-based stress management program was effective for improving knowledge about stress management. It was also effective for improving coping skills in instances where participants had enough time (at least 3 d) to complete all sessions.     

Dietary Intervention Effectiveness,Clinical Outcomes and Nutrient and Salicylate Intakes in Older Adults Living in Long-Term Care Homes: The Results from the Senior’s Plate Project

Optimal nutrition is an important part of the therapeutic process offered to patients in long-term care, as it can significantly influence their nutritional and health status. The aim of this study was to assess the impacts of a dietary intervention on the nutritional status, clinical outcomes and selected nutrient and salicylate intakes among older adults living in a long-term care nursing home. To achieve the research goal, a prospective, non-randomized, baseline-controlled intervention study was conducted. The study was conducted within the framework of the “Senior’s Plate Project”, a project established in 2018 by the Polish Society of Dietetics. Methods: A 3 month dietary intervention, which included one serving of supplementary food, served as a second breakfast (Nestle Sinlac). Energy, nutrients and salicylates intakes were estimated on the basis of the menus. Food and beverage intakes among residents were verified by health care personnel. Anthropometric measurements and clinical examinations were conducted according to standard procedures at baseline and after intervention. Results: Of the 38 residents qualified for the study, 29 completed the program. Residents’ body mass index (BMI) values ranged from 13.3 kg/m² to 34 kg/m². A BMI < 22 kg/m², indicating underweight, was found in 19 subjects. The dietary intervention resulted in increased body weight (57.8 ± 12.3 vs. 59.4 ± 12.6 kg), BMI (22.4 ± 4.0 vs. 23.0 ± 4.1 kg/m²) and body fat (19.2 ± 8.7 vs. 20.6 ± 8.9 kg). Significant changes in the levels of biochemical parameters, including serum calcium (8.7 vs. 9.5 mg/dL), potassium (4.1 ± 0.6 vs. 4.5 ± 0.5 mmol/L) and zinc (74.1 ± 10.9 vs. 109.0 ± 20.4 µg/dL), were observed. Energy, protein, fat and carbohydrate intakes were significantly higher in the third month of the intervention as compared to the baseline. The estimated medial daily intake of salicylates was low and ranged from 0.34 mg to 0.39 mg. Conclusions: The dietary intervention resulted in beneficial and significant changes in the nutritional status, biochemical parameters and nutrition of residents of the long-term care home. These results suggest that practical and individualized approaches are required to improve the nutritional status and clinical outcomes of nursing homes residents.     

Child health promotion program in South Korea in collaboration with US National Aeronautics and Space Administration: Improvement in dietary and nutrition knowledge of young children

BACKGROUND/OBJECTIVESChildhood obesity has become a global epidemic. Development of effective and sustainable programs to promote healthy behaviors from a young age is important. This study developed and tested an intervention program designed to promote healthy eating and physical activity among young children in South Korea by adaptation of the US National Aeronautics and Space Administration (NASA) Mission X (MX) Program.SUBJECTS/METHODSThe intervention program consisted of 4 weeks of fitness and 2 weeks of nutrition education. A sample of 104 subjects completed pre- and post-surveys on the Children''s Nutrition Acknowledgement Test (NAT). Parents were asked for their children''s characteristics and two 24-hour dietary records, the Nutrition Quotient (NQ) at baseline and a 6-week follow-up. Child weight status was assessed using Korean body mass index (BMI) percentiles.RESULTSAt baseline, 16.4% (boy: 15.4%; girl: 19.2%) of subjects were overweight or obese (based on BMI≥85%tile). Fat consumption significantly decreased in normal BMI children (48.6 ± 16.8 g at baseline to 41.9 ± 18.1 g after intervention, P < 0.05); total NQ score significantly increased from 66.4 to 67.9 (P < 0.05); total NAT score significantly improved in normal BMI children (74.3 at baseline to 81.9 after the program), children being underweight (from 71.0 to 77.0), and overweight children (77.1 at baseline vs. 88.2 after intervention, P < 0.001).CONCLUSIONSThe 6-week South Korean NASA MX project is feasible and shows favorable changes in eating behaviors and nutritional knowledge among young children.     

The effect of an application-based educational intervention with a social cognitive theory model on pregnant women in Denpasar,Bali, Indonesia: a randomized controlled trial

ObjectivesThe aim of this study was to elucidate the effect of application-based antenatal education based on social cognitive theory (SCT) on Health Promoting Lifestyle Profile II (HPLP II) scores, compliance with iron tablet consumption, and readiness for childbirth and complications among pregnant women in Denpasar, Bali, Indonesia.Methods This randomized controlled trial included 71 pregnant women in the treatment group and 74 pregnant women in the control group. The treatment group application-based antenatal education based on SCT, while the control group attended a conventional pregnancy class. Iron tablet consumption was verified by counting the remaining iron tablets. Information on participants’ lifestyles was collected using the HPLP II questionnaire with the help of an assistant. The collected data were statistically analyzed using IBM SPSS ver. 24.0.Results The antenatal education intervention effectively increased the HPLP II score by 0.32 points (2.62±0.331 before the intervention and 2.94±0.273 after). Meanwhile, the control group had a 0.13-point increase (p=0.001), from 2.67±0.336 to 2.80±0.275. There was no significant difference in iron tablet consumption (p=0.333) or readiness for delivery and complications (p=0.557) between the treatment and control groups.Conclusion Application-based antenatal education with SCT effectively increased the HPLP II scores of pregnant women in Denpasar, Bali. Although there was no significant difference in iron tablet consumption or readiness for delivery and complications, the values increased to a greater extent in the treatment group than in the control group. This education model is more suited to urban pregnant women who employed and have good internet access.     

Women’s Empowerment Facilitates Complete Immunization in Indonesian Children: A Cross-sectional Study

ObjectivesThe primary objective of this study was to examine the effect of women’s empowerment on the immunization of Indonesian children. The secondary objective was to examine the effect of wealth as a factor modifying this association.MethodsWe utilized data from the 2017 Indonesian Demographic and Health Survey (IDHS). The subjects were married women with children aged 12–23 months (n=3532). Complete immunization was defined using the 2017 IDHS definition. Multiple components of women’s empowerment were measured: enabling resources, decision-making involvement, and attitude toward intimate partner violence. The primary analysis was conducted using binomial logistic regression. Model 1 represented only the indicators of women’s empowerment and model 2 controlled for socio-demographic variables. Subgroup analyses were conducted for each wealth group.ResultsThe primary analysis using model 1 identified several empowerment indicators that facilitated complete immunization. The analysis using model 2 found that maternal education and involvement in decision-making processes facilitated complete immunization in children. Subgroup analyses identified that wealth had a modifying effect. The indicators of women’s empowerment were strong determinants of complete immunization in lower wealth quintiles but insignificant in middle-income and higher-income quintiles.ConclusionsTo our knowledge, this study is the first to explore women’s empowerment as a determinant of child immunization in Indonesia. The results indicate that women’s empowerment must be considered in Indonesia’s child immunization program. Women’s empowerment was not found to be a determinant in higher wealth quintiles, which led us to rethink the conceptual framework of the effect of women’s empowerment on health outcomes.     

Prenatal Maternal Docosahexaenoic Acid (DHA) Supplementation and Newborn Anthropometry in India: Findings from DHANI

Long-chain omega-3 fatty acid status during pregnancy may influence newborn anthropometry and duration of gestation. Evidence from high-quality trials from low- and middle-income countries (LMICs) is limited. We conducted a double-blind, randomized, placebo-controlled trial among 957 pregnant women (singleton gestation, 14–20 weeks’ gestation at enrollment) in India to test the effectiveness of 400 mg/day algal docosahexaenoic acid (DHA) compared to placebo provided from enrollment through delivery. Among 3379 women who were screened, 1171 were found eligible; 957 were enrolled and were randomized. The intervention was two microencapsulated algal DHA (200 × 2 = 400 mg/day) or two microencapsulated soy and corn oil placebo tablets to be consumed daily from enrollment (≤20 weeks) through delivery. The primary outcome was newborn anthropometry (birth weight, length, head circumference). Secondary outcomes were gestational age and 1 and 5 min Appearance, Pulse, Grimace, Activity, and Respiration (APGAR) score. The groups (DHA; n = 478 and placebo; n = 479) were well balanced at baseline. There were 902 live births. Compliance with the intervention was similar across groups (DHA: 88.5%; placebo: 87.1%). There were no significant differences between DHA and placebo groups for birth weight (2750.6 ± 421.5 vs. 2768.2 ± 436.6 g, p = 0.54), length (47.3 ± 2.0 vs. 47.5 ± 2.0 cm, p = 0.13), or head circumference (33.7 ± 1.4 vs. 33.8 ± 1.4 cm, p = 0.15). The mean gestational age at delivery was similar between groups (DHA: 38.8 ± 1.7 placebo: 38.8 ± 1.7 wk, p = 0.54) as were APGAR scores at 1 and 5 min. Supplementing mothers through pregnancy with 400 mg/day DHA did not impact the offspring‘s birthweight, length, or head circumference.     

Differences of expected intervention effects between participant-led and facilitator-led preventive care services in Japan

ObjectiveTo examine the effect of different management methods on the effectiveness of care preventive programmes for community-dwelling older adults.MethodsThis study comprised two facilitator-led (FL) and one participant-led (PL) preventive care classes in Japan. All participants received the intervention for approximately 12 weeks. Functional assessments, occupational dysfunctions, and subjective health were measured before and after the interventions. A two-way mixed design analysis of covariance (ANCOVA) was adopted to examine the effect of the interventions, adjusted for previous experiences with preventive care services. The level of significance was set at P < 0.05.ResultsFourteen participants in the PL group (76.64 ± 6.48 years, 92.9% women) and 29 participants in the FL group (76.55 ± 5.75 years, 75.9% women) were included in the statistical analysis. ANCOVA showed significant group × time interaction effects in the Five Times Sit-to-Stand Test (FTSST), the Timed Up & Go (TUG), occupational deprivation of the Classification and Assessment of Occupational Dysfunction Scale, and self-rated health. Simple main effect tests showed that the TUG decreased significantly in the PL group, while occupational deprivation and self-rated health scores improved significantly. In contrast, FTSST scores significantly improved in the FL group.ConclusionPL-type management may be more appropriate for preventing social isolation and withdrawal, while FL-type management may be more appropriate for preventing physical frailty. Selecting not only adequate programmes but also an appropriate management type that matches the service purpose can help provide more effective care preventive services.     

Psychometric characteristics of the health care empowerment questionnaire in a sample of patients with arthritis and rheumatic conditions

BackgroundPatient empowerment can improve health‐related outcomes and is important in chronic conditions, such as arthritis. This study aimed to validate the Health Care Empowerment Questionnaire (HCEQ), a patient‐reported experience measure of empowerment, for use with patients with arthritis and other rheumatic diseases.MethodsThe HCEQ measures Patient Information Seeking (or Involvement in Decisions) and Healthcare Interaction Results (or Involvement in Interactions) and asks respondents to answer questions in two ways: whether they feel something happened and its importance to them. Face validity was assessed through qualitative data (n = 8, nominal group technique; n = 55, focus groups). Measure structure was assessed through confirmatory factor analysis (CFA); internal consistency was also assessed (n = 9226). Test‐retest reliability was assessed with sub‐sample of participants (n = 182).ResultsWe found adequate face validity of the HCEQ for patients with arthritis. The CFA indicated good fit to the data for the two‐factor structure of the HCEQ (RMSEA = 0.075; CFI = 0.987; TLI = 0.978; SRMR = 0.026). Internal consistency was strong (α=0.94 for both subscales). Test‐retest reliability was moderate for Patient Information Seeking (ICC=0.67) and good for Healthcare Interaction Results (ICC=0.77).ConclusionsThe HCEQ, with modifications, demonstrated promising psychometric properties within this sample, laying the foundation for further assessment. This work supports the HCEQ as an appropriate instrument for examining experiences with and perceived importance of empowerment in individuals with arthritis and other rheumatic conditions.Patient ContributionPatients contributed to the assessment of face validity. As a measure of patient empowerment, the HCEQ’s use can enable further participation of patients in health care.     

How does accelerometry-measured arm elevation at work influence prospective risk of long-term sickness absence?

ObjectiveElevated arm work is prevalent in many jobs. Feasible device-based methods are available to measure elevated arm work. However, we lack knowledge on the association between device-measured elevated arm work and prospective risk of long-term sickness absence (LTSA). We aimed to investigate this association.MethodsAt baseline, 937 workers wore accelerometers on the right arm and thigh over 1–5 workdays to measure work time spent with elevated arms in an upright position. Between baseline and 4-year prospective follow-up in the national registers, we obtained information on the individuals’ first event of LTSA (≥6 consecutive weeks). We performed compositional Cox proportional hazard analyses to model the association between work time with arm elevation >30°, >60°, or >90° and the probability of LTSA.ResultsWorkers spent 21% of their work time with >30° arm elevation, 4% with >60° arm elevation, and 1% with >90° arm elevation; in the upright body position. We found a positive dose–response association between work time spent with elevated arm work and the risk of LTSA. Specifically, we found that increasing two minutes of work time spent with arm elevation at (i) >90° increased the risk of LTSA by 14% [hazard ratio (HR) 1.14, 95% confidence intervals (95% CI 1.04–1.25)] (ii) >60° increased the LTSA risk by 3% (HR 1.03, 95% CI 1.03–1.06), and (iii) >30° increased the LTSA risk by 1% (HR 1.01, 95% CI 1.00–1.02).ConclusionDevice-measured elevated arm work is associated with increased prospective LTSA. This information ought to be brought into preventive workplace practice by accessible and feasible device-based methods of elevated arm work.     

Dietary Intake Patterns and Lifestyle Behaviors of Pregnant Women Living in a Manitoba First Nations Community: Implications for Fetal Alcohol Spectrum Disorder

The information on the nutrition status of women at-risk of carrying a child with fetal alcohol spectrum disorder (FASD) is scarce, particularly in the First Nations population living on reserve. This study examined and compared nutrition status, dietary intake, and lifestyle patterns of pregnant at-risk, defined as those who consume alcoholic drink during the current pregnancy, and non-at-risk women living in northern Manitoban community. Thirty-seven pregnant, First Nations women (at-risk n = 15; non-at-risk, n = 22) were recruited to participate in the study. A questionnaire, presented in paper and iPad formats, collected information on participants’ demographics, dietary intake, lifestyle, pregnancy outcomes, and maternal health. A food frequency questionnaire and 24-h recall were used to determine nutrient intake. Nutrient values were assessed using Dietary Reference Intakes (DRI). At-risk and non-at-risk women were below the Canada Food Guide serving size recommended for Vegetable and Fruit, Grain, and Milk Products with 93%, 92%, and 93% of participants not meeting the recommendations, respectively. Women met the recommendations for vitamins A, B1, B12, C, niacin, choline, as well as calcium, and zinc. Sixty eight percentage (%) of participants did not meet the recommendations for folate and iron, and 97% for docosahexaenoic acid (DHA). Significant differences were observed between non-at-risk and at-risk women for mean % DRI intakes of vitamin C (313 ± 224 vs. 172 ± 81 mg/day), niacin (281 ± 123 vs. 198 ± 80 mg/day), folate (70 ± 38 vs. 10 ± 22 mcg/day), and iron (101 ± 74 vs. 74 ± 30 mg/day). The findings of this study lay a fundamental premise for the development of community nutrition programs, nutrition education, and nutrition intervention, such as community specific prenatal supplementation. These will assist in ensuring adequate maternal nutrient intake and benefit families and communities in Northern Manitoba with and without alcohol insult.     

Iodine Status of Women of Reproductive Age in Sierra Leone and Its Association with Household Coverage with Adequately Iodized Salt

Salt iodization programs are a public health success in tackling iodine deficiency. Yet, a large proportion of the world’s population remains at risk for iodine deficiency. In a nationally representative cross-sectional survey in Sierra Leone, household salt samples and women’s urine samples were quantitatively analyzed for iodine content. Salt was collected from 1123 households, and urine samples from 817 non-pregnant and 154 pregnant women. Household coverage with adequately iodized salt (≥15 mg/kg iodine) was 80.7%. The median urinary iodine concentration (UIC) of pregnant women was 175.8 µg/L and of non-pregnant women 190.8 µg/L. Women living in households with adequately iodized salt had higher median UIC (for pregnant women: 180.6 µg/L vs. 100.8 µg/L, respectively, p < 0.05; and for non-pregnant women: 211.3 µg/L vs. 97.8 µg/L, p < 0.001). Differences in UIC by residence, region, household wealth, and women’s education were much smaller in women living in households with adequately iodized salt than in households without. Despite the high household coverage of iodized salt in Sierra Leone, it is important to reach the 20% of households not consuming adequately iodized salt. Salt iodization has the potential for increasing equity in iodine status even with the persistence of other risk factors for deficiency.     

Work hazards and workers’ mental health: an investigation based on the fifth European Working Conditions Survey

Background:Workplace hazards are a significant source of health impairment for workers and of financial losses for firms. EU directives on workers’ health and safety standards significantly contributed to reduce reported occupational injuries, yet the incidence and prevalence of work-related mental illness is still very high.Objectives:We investigated the association between work-related hazards and individuals’ perceived mental health. We reviewed the existing evidence on the channels through which task-related factors, adverse agents and psychosocial factors are expected to affect workers’ health, with specific regard to mental health.Methods:We used data from the fifth wave of the European Working Conditions Survey, covering over 40,000 face-to-face interviews with workers in 34 countries, which includes information on socio-demographic characteristics, firms and jobs attributes, employment status, as well as working conditions and health status. We carried out an empirical analysis with multivariate regression models in order to estimate the relationship between workers’ mental health problems and workplace risk factors.Results:21,020 interviews were used in the multivariate analysis. We found strong correlations between hazards and various indicators of mental health. Among hazardous agents, low temperatures (β=0.0287) and contact with infectious materials (β=0.0394) were positively associated with mental health outcomes. Among task/sequence-related factors, tiring or painful positions (β=0.0713), repetitive hand/arm movements (β=0.0255), working with VDUs (β=0.0301), repetitive tasks <10 min (β=0.0859) and working in evenings (β=0.00754) were positively associated with mental health. Various psychosocial risk factors related to both the content of the job (for example, frequent disruptive interruptions: β=0.219, working in free time: β=0.0759, poor work-life balance: β=0.228) as well as the job context (for example, bad employment prospects: β=0.177, low decisional autonomy: β=0.245, bad social relations: β=0.186, workplace violence: β=0.411) were positively associated with mental health. The main results of the decomposition show that an important contribution to workers’ overall mental distress at work is associated with psychosocial risk factors (up to 60% for depression/anxiety symptoms and sleep disorders), while the contribution of somatic factors is on average lower (up to 20% for overall fatigue).Conclusions:We argue that action is needed to improve workers’ mental well-being, and reduce the economic costs for both the national health system and employers. Regulations and traditional economic measures are unlikely to prove successful in providing adequate standards of primary and secondary preventive measures in the work place without an appropriate and reliable Risk Assessment Procedure.Key words: Work hazards, risk assessment, job content, mental health     

Biomonitoring Findings for Occupational Lead Exposure in Battery and Ceramic Tile Workers using Biochemical Markers,Alkaline Comet Assay,and Micronucleus Test Coupled with Fluorescence in Situ Hybridisation

Manufacture of lead-containing products has long been associated with various health risks. To get an insight into the related genotoxic risks, we conducted a biomonitoring study in 50 exposed workers and 48 matched controls using a battery of endpoints that sensitively detect the extent of genome instability in peripheral blood lymphocytes. The levels of primary DNA damage were estimated with the alkaline comet assay, while cytogenetic abnormalities were determined with the cytokinesis-block micronucleus (CBMN) cytome assay. Additionally, CBMN slides of 20 exposed and 16 control participants were subjected to fluorescence in situ hybridisation (FISH), coupled with pancentromeric probes to establish the incidence of centromere-positive micronuclei, nuclear buds, and nucleoplasmic bridges. Blood lead levels (B-Pb) were measured with atomic absorption spectrometry. To further characterise cumulative effects of occupational exposure, we measured erythrocyte protoporphyrin (EP) concentrations and delta-aminolevulinic acid dehydratase (ALAD) activity in blood. We also assessed the influence of serum folate (S-folate) and vitamin B₁₂ (S-B12) on genome stability. Compared to controls, occupationally exposed workers demonstrated significantly higher B-Pb (298.36±162.07 vs 41.58±23.02), MN frequency (18.71±11.06 vs 8.98±7.50), centromere positive MN (C+ MN) (8.15±1.8 vs 3.69±0.47), and centromere negative MN (C- MN) (14.55±1.80 vs 4.56±0.89). Exposed women had significantly higher comet tail intensity (TI) and length (TL) than control women. Furthermore, workers showed a positive correlation between age and nuclear buds and MN, between MN and years of exposure, and between S-B₁₂ levels and TI and ALAD activity, while a negative correlation was found between TI and B-Pb. These findings suggest that occupational settings in the manufacture of lead-containing products pose significant genotoxic risks, which calls for developing more effective work safety programmes, including periodical monitoring of B-Pb and genetic endpoints.Key words: blood lead, genetic endpoints, genome damage, human lymphocytes, MN-FISH     

Gut Microbiome and Metabolome Variations in Self-Identified Muscle Builders Who Report Using Protein Supplements

Muscle builders frequently consume protein supplements, but little is known about their effect on the gut microbiota. This study compared the gut microbiome and metabolome of self-identified muscle builders who did or did not report consuming a protein supplement. Twenty-two participants (14 males and 8 females) consumed a protein supplement (PS), and seventeen participants (12 males and 5 females) did not (No PS). Participants provided a fecal sample and completed a 24-h food recall (ASA24). The PS group consumed significantly more protein (118 ± 12 g No PS vs. 169 ± 18 g PS, p = 0.02). Fecal metabolome and microbiome were analyzed by using untargeted metabolomics and 16S rRNA gene sequencing, respectively. Metabolomic analysis identified distinct metabolic profiles driven by allantoin (VIP score = 2.85, PS 2.3-fold higher), a catabolic product of uric acid. High-protein diets contain large quantities of purines, which gut microbes degrade to uric acid and then allantoin. The bacteria order Lactobacillales was higher in the PS group (22.6 ± 49 No PS vs. 136.5 ± 38.1, PS (p = 0.007)), and this bacteria family facilitates purine absorption and uric acid decomposition. Bacterial genes associated with nucleotide metabolism pathways (p < 0.001) were more highly expressed in the No PS group. Both fecal metagenomic and metabolomic analyses revealed that the PS group’s higher protein intake impacted nitrogen metabolism, specifically altering nucleotide degradation.     

Correlates of Engagement Within an Online HIV Prevention Intervention for Single Young Men Who Have Sex With Men: Randomized Controlled Trial

BackgroundDigital HIV interventions (DHI) have been efficacious in reducing sexual risk behaviors among sexual minority populations, yet challenges in promoting and sustaining users’ engagement in DHI persist. Understanding the correlates of DHI engagement and their impact on HIV-related outcomes remains a priority. This study used data from a DHI (myDEx) designed to promote HIV prevention behaviors among single young men who have sex with men (YMSM; ages 18-24 years) seeking partners online.ObjectiveThe goal of this study is to conduct a secondary analysis of the myDex project data to examine whether YMSM’s online behaviors (eg, online partner-seeking behaviors and motivations) are linked to participants’ engagement (ie, the number of log-ins and the number of sessions viewed).MethodsWe recruited 180 YMSM who were randomized into either myDEx arm or attention-control arm using a stratified 2:1 block randomization. In the myDEx arm, we had 120 YMSM who had access to the 6-session intervention content over a 3-month period. We used Poisson regressions to assess the association between YMSM’s baseline characteristics on their DHI engagement. We then examined the association between the participants’ engagement and their self-reported changes in HIV-related outcomes at the 3-month follow-up.ResultsThe mean number of log-ins was 5.44 (range 2-14), and the number of sessions viewed was 6.93 (range 0-22) across the 3-month trial period. In multivariable models, the number of log-ins was positively associated with high education attainment (estimated Poisson regression coefficient [β]=.22; P=.045). The number of sessions viewed was associated with several baseline characteristics, including the greater number of sessions viewed among non-Hispanic YMSM (β=.27; P=.002), higher education attainment (β=.22; P=.003), higher perceived usefulness of online dating for hookups (β=.13; P=.002) and perceived loneliness (β=.06; P=.004), as well as lower experienced online discrimination (β=–.01; P=.007) and limerence (β=–.02; P=.004). The number of sessions viewed was negatively associated with changes in internalized homophobia (β=–.06; P<.001) and with changes in perceived usefulness of online dating for hookups (β=–.20; P<.001). There were no significant associations between the number of log-ins and changes in the participants’ behaviors at the 90-day follow-up.ConclusionsDHI engagement is linked to participants’ sociodemographic and online behaviors. Given the importance of intervention engagement in the intervention’s effectiveness, DHIs with personalized intervention components that consider the individuals’ differences could increase the overall engagement and efficacy of DHIs.Trial RegistrationClinicalTrials.gov {"type":"clinical-trial","attrs":{"text":"NCT02842060","term_id":"NCT02842060"}}NCT02842060; https://clinicaltrials.gov/ct2/show/{"type":"clinical-trial","attrs":{"text":"NCT02842060","term_id":"NCT02842060"}}NCT02842060.     

Adiponectin Gene Variant rs3774261, Effects on Lipid Profile and Adiponectin Levels after a High Polyunsaturated Fat Hypocaloric Diet with Mediterranean Pattern

The role of ADIPOQ gene variants on metabolic improvements after weight change secondary to different hypocaloric diets remained unclear. We evaluate the effect of rs3774261 of ADIPOQ gene polymorphism on biochemical improvements and weight change after high polyunsaturated fat hypocaloric diet with a Mediterranean dietary pattern for 12 weeks. A population of 361 obese subjects was enrolled in an intervention trial with a calorie restriction of 500 calories over the usual intake and 45.7% of carbohydrates, 34.4% of fats, and 19.9% of proteins. The percentages of different fats was; 21.8% of monounsaturated fats, 55.5% of saturated fats, and 22.7% of polyunsaturated fats. Before and after intervention, an anthropometric study, an evaluation of nutritional intake and a biochemical evaluation were realized. All patients lost weight regardless of genotype and diet used. After 12 weeks with a similar improvement in weight loss (AA vs. AG vs. GG); total cholesterol (delta: −28.1 ± 2.1 mg/dL vs. −14.2 ± 4.1 mg/dL vs. −11.0 ± 3.9 mg/dL; p = 0.02), LDL cholesterol (delta: −17.1 ± 2.1 mg/dL vs. −6.1 ± 1.9 mg/dL vs. −6.0 ± 2.3 mg/dL; p = 0.01), triglyceride levels (delta: −35.0 ± 3.6 mg/dL vs. 10.1 ± 3.2 mg/dL vs. −9.7 ± 3.1 mg/dL; p = 0.02), C reactive protein (CRP) (delta: −2.3 ± 0.1 mg/dL vs. −0.2 ± 0.1 mg/dL vs. −0.2 ± 0.1 mg/dL; p = 0.02), serum adiponectin (delta: 11.6 ± 2.9 ng/dL vs. 2.1 ± 1.3 ng/dL vs. 3.3 ± 1.1 ng/dL; p = 0.02) and adiponectin/leptin ratio (delta: 1.5 ± 0.1 ng/dL vs. 0.3 ± 0.2 ng/dL vs. 0.4 ± 0.3 ng/dL; p = 0.03), improved only in AA group. AA genotype of ADIPOQ variant (rs3774261) is related with a significant increase in serum levels of adiponectin and ratio adiponectin/leptin and decrease on lipid profile and C-reactive protein (CRP).     

Health-Promoting Behaviors Through Pregnancy,Maternity Leave,and Return to Work: Effects of Role Spillover and Other Correlates

ABSTRACT

Women's health-promoting behavior changes and their correlates across the transition to motherhood and return to work are insufficiently understood. The purpose of this study was to describe and compare women's health-promoting behaviors, particularly physical activity (PA), across these transitions.

A prospective, observational design was employed to assess 243 female healthcare workers from 3 sites with regard to health-promoting behaviors, and their demographic (e.g., age, parity) and psychosocial (i.e., work-family role spillover) correlates. Forty-two participants were recruited while pregnant and re-assessed during maternity leave and upon return to work, and compared to 201 non-pregnant participants.

No significant changes in health-promoting behaviors were observed from pregnancy through the postpartum. Pregnant participants reported better nutrition than comparison participants (p = .001), and were more likely to check their pulse when exercising (p = .004). During pregnancy, health-promoting behaviors were related to parental status, with first-time mothers engaging in more positive behaviors. Correlates of PA during maternity leave and return to work included family income and exercise history. Positive family-to-work spillover was significantly greater among pregnant women than among comparison participants (p < .001), and positive work-to-family spillover was related to greater PA upon return to work (p < .01).

This study reveals little variability in health-promoting behaviors from the prenatal to the postpartum period. Both demographic and psychosocial factors have effects on health-promoting behaviors, and we must look to these correlates to promote increased PA.     

A Pilot Study of the Effect of Lactobacillus casei Obtained from Long-Lived Elderly on Blood Biochemical,Oxidative, and Inflammatory Markers,and on Gut Microbiota in Young Volunteers

Probiotic intake has been shown to improve certain physiological health indicators. We aimed to examine effects of Lactobacillus casei LTL1879, obtained from long-lived elderly volunteers, on blood biochemical, oxidative, and inflammatory markers and gut microbiota in twenty healthy, young volunteers. Volunteers were randomly divided into equal probiotic and placebo groups and changes in blood biochemical indicators, oxidative and inflammatory markers, and gut microbiota were examined after three weeks of probiotic intervention. The probiotic group’s antioxidant levels were significantly enhanced post-intervention. Total antioxidant capacity (T-AOC) levels were significantly increased (p < 0.0001), while malondialdehyde (MDA) levels decreased (p < 0.05), and total superoxide dismutase (T-SOD) levels increased, but with no significant difference. In addition, Interleukin-10 (IL-10) and tumor necrosis factor-α (TNF-α) levels were significantly up-regulated and down-regulated (p < 0.05, respectively). Escherichia coli, Enterococcus, and Bacteroides expression was significantly reduced (p < 0.05), while Clostridium leptum, Bifidobacterium, and Lactobacillus expression increased (p < 0.05). Volunteer health status was quantified using principal components and cluster analysis, indicating that the probiotic group’s overall score was higher than that of the placebo group. The results of this pilot study suggest L. casei LTL 1879 can significantly improve specific immune, oxidative, and gut microbiota characteristics related to health factors.     

Marine n-3 Polyunsaturated Fatty Acids and Bone Mineral Density in Kidney Transplant Recipients: A Randomized,Placebo-Controlled Trial

Kidney transplant recipients are at high risk of progressive bone loss and low-energy fractures in the years following transplantation. Marine n-3 polyunsaturated fatty acids (n-3 PUFA) supplementation may have beneficial effects on bone strength. The Omega-3 fatty acids in Renal Transplantation (ORENTRA) trial was an investigator initiated, randomized, placebo-controlled trial investigating the effects of marine n-3 PUFA supplementation after kidney transplantation. Effects of supplementation on bone mineral density (BMD) and calcium metabolism were pre-defined secondary endpoints. Adult kidney transplant recipients (n = 132) were randomized to 2.6 g marine n-3 PUFA supplement or olive oil (control) from 8 to 52 weeks post-transplant. Dual energy X-ray absorptiometry was performed to assess changes in bone mineral density of hip, spine, and forearm, as well as trabecular bone score (TBS) of the lumbar spine. Student’s t test was used to assess between-group differences. There were no differences in ΔBMD between the two groups (intervention vs. control) at lumbar spine (−0.020 ± 0.08 vs. −0.007 ± 0.07 g/cm², p = 0.34), total hip (0.001 ± 0.03 vs. −0.005 ± 0.04, p = 0.38), or other skeletal sites in the intention-to-treat analyses. There was no difference in the change in TBS score (0.001 ± 0.096 vs. 0.009 ± 0.102, p = 0.62). Finally, no effect on biochemical parameters of mineral metabolism was seen. Results were similar when analyzed per protocol. In conclusion, we found no significant effect of 44 weeks of supplementation with 2.6 g of marine n-3 PUFA on BMD in kidney transplant recipients.     

Nursing staff fatigue and burnout during the COVID-19 pandemic in Greece

IntroductionThe coronavirus pandemic (COVID-19) is an unprecedented global health crisis with emotional and physical impact on health care workers.ObjectiveThe purpose of this study was to investigate the levels of fatigue and burnout in nursing staff during the pandemic.MethodsThe present study involved nursing staff from hospitals in Greece in February 2021, who completed the Fatigue (FAS) and Burnout (CBI) questionnaires. Gender, age, years of work experience, workplace (COVID-19 or non-COVID-19 wards) and SARS-CoV-2 infection status were recorded.ResultsThe sample included 593 women and 108 men, with a mean age ± SD: 42.9 ± 9.9 years and 18.14 ± 10.8 years work experience. Slightly more than half, (367, 52.4%) worked in COVID-19 departments. Fifty-six (8%) tested positive for SARS-CoV-2 and 14 of them needed to be treated. The mean ± SD FAS and CBI scores were 25.6 ± 7.4 and 46.9 ± 18.8, respectively (67.9% and 42.9% had scores suggestive of fatigue and burnout, respectively). Women showed higher values in both scales (p < 0.01). Subjects working in COVID-19 wards scored significantly higher on both the FAS and CBI scales; they were also younger and with less work experience (p < 0.01). Staff treated for COVID-19 scored higher on the burnout scale (p < 0.01) than the uninfected staff. Fatigue showed a strong positive correlation with burnout (p < 0.01, r = 0.70). Stepwise multiple regression showed that the variation of fatigue was explained by 47.0% and 6.1% by the scores on the subscales of personal and work-related burnout, respectively.ConclusionIn conclusion, high rates of fatigue and burnout were found in the studied population. Nurses working with COVID-19 patients had higher rates of fatigue and burnout compared to those working elsewhere. There was a strong positive correlation (r = 0.70) between burnout and fatigue. Particular attention should be paid to staff who became ill and need to be treated.