Trust and confidence in using telehealth in people with chronic kidney disease: A cross-sectional study

Consumer trust and confidence in telehealth is pivotal to successful service implementation and effective consultations. This cross-sectional study measured trust and confidence in telephone and video consultations and associated with experience in telehealth modalities among people with chronic kidney disease at a metropolitan hospital in Australia. Self-report data were collected using validated trust and confidence in telehealth scales and 5-point Likert responses. Non-parametric tests were used to compare trust and confidence in telephone and video consultations (Wilcoxon Matched Pairs) and associations with telehealth experience (Mann-Whitney). Of the 156 survey participants, 96.2% had used telephone consultations and 28.9% had used video. Overall trust and confidence in using telehealth were high. Confidence (range 1-5) in using telephone consultations (mean 3.75 ± 0.71) was significantly higher than video consultation (mean 3.64 ± 0.74), p = 0.039. Trust in telephone consultations (mean 3.93 ± 0.64) was significantly higher than in video consultations (mean 3.67 ± 0.66), p < 0.001. There was a significant association between experience with telephone consultations and reported levels of trust and confidence in telephone consultations. Experience with video was significantly related to trust in video consultations, but not confidence. Given the substantial difference in experience between telehealth modalities, trust and confidence may change as further exposure occurs.

Insufficient physical activity and high sedentary behaviour are associated with loneliness in adolescents with overweight/obesity: Evidence from 23 low- and middle-income countries

BACKGROUND/OBJECTIVES

Overweight and obesity among young people is a major concern with implications for social wellbeing. We aimed to evaluate the associations of physical activity (PA) and sedentary behaviour (SB) with loneliness among adolescents with overweight/obesity.

METHODS

Data were used from the Global School-based Student Health Surveys, collected from 23 low-and-middle-income countries.

RESULTS

Of the 12,133 participants aged 12-17 years with overweight/obesity (48.4% girls), 12% were lonely, with a wide variation across countries ranging from 4% in Laos to 32% in Afghanistan. Overall, 31% had high SB (≥3 hours/day) and 86% were not sufficiently active (<7 days/week of ≥ 60 mins/day). High SB and insufficient PA were positively associated with loneliness (aOR 1.22, 95% CI 1.08-1.38, aOR 1.37, 95% CI 1.18-1.59, respectively).

CONCLUSIONS

Future research could examine the direction of these relationships and evaluate strategies to optimise these indicators of social wellbeing among adolescents with overweight/obesity.

Positive HABITATS for physical activity: Examining use of parks and its contribution to physical activity levels in mid-to older-aged adults

Studies of parks and physical activity rarely identify the actual spaces participants use. Using data from the HABITAT project, a longitudinal cohort of mid-to older-aged (40-70 years) respondents (n = 11,036) living in Brisbane Australia, this study examined (1) the demographic characteristics of users and non-users of parks; (2) the park used and the characteristics and features of the most popular reported spaces; and (3) the level of physical activity undertaken in the reported parks and whether users had higher total physical activity levels than non-users. Park use was significantly higher (p < 0.01) among dog walkers, couples (over 40) living with children, and those living in least disadvantaged areas. Regular park use was significantly higher among users of larger-sized neighbourhood and district-catchment parks. Park users were 35% more likely to meet the physical activity guidelines (OR = 1.35, 95%CI 1.21-1.50, p < 0.001) compared with those who indicated they did nto regularly use a park. The size of the park used was positively associated with participation in physical activity. Users of larger-sized parks spent more time doing vigorous activity and engaged in more activity sessions than non-users. Future data obtained from large populations, including spatial examination of the actual parks used and their characteristics, are essential to facilitate planning for park provision, optimising the use of these spaces for recreation and physical activity by mid-to older-aged adults, and creating healthy communities.

Reliability and validity of a self-administered Arabic version of the Global Physical Activity Questionnaire (GPAQ-A)

BACKGROUND

The primary objective of this study was to assess the test-retest reliability of the Arabic language version of the Global Physical Activity Questionnaire (GPAQ-A). Additionally, the study assessed criterion validity of the instrument.

METHODS

Emirati university students (N.=93) were asked to complete the GPAQ-A on two occasions (7 days apart). A subset of 48 participants wore an accelerometer for 7 days after which they completed the GPAQ-A.

RESULTS

Test-retest reliability of the GPAQ-A was acceptable for moderate to vigorous physical activity (MVPA) (ρ=0.78; 95% CI: 0.69 to 0.86), moderate physical activity (MPA) (ρ=0.73; 95% CI: 0.61 to 0.82) and vigorous physical activity (VPA) (ρ=0.62; 95% CI: 0.44 to 0.76). Test-retest reliability of the single item sedentary behavior (SB) measure was less promising (ρ=0.44; 95% CI: 0.22 to 0.64). Criterion validity of the MVPA measure was fair (ρ=0.23; 95% CI: -0.13 to 0.57).

CONCLUSIONS

Test-retest reliability for the GPAQ-A was acceptable to assess physical activity (PA) but less promising for SB. Criterion validity of the PA measures was fair. Additional work is needed to develop robust measures of PA and SB in this population.

Atmospheric CH4 oxidation by Arctic permafrost and mineral cryosols as a function of water saturation and temperature

The response of methanotrophic bacteria capable of oxidizing atmospheric CH₄ to climate warming is poorly understood, especially for those present in Arctic mineral cryosols. The atmospheric CH₄ oxidation rates were measured in microcosms incubated at 4 °C and 10 °C along a 1-m depth profile and over a range of water saturation conditions for mineral cryosols containing type I and type II methanotrophs from Axel Heiberg Island (AHI), Nunavut, Canada. The cryosols exhibited net consumption of ~2 ppmv CH₄ under all conditions, including during anaerobic incubations. Methane oxidation rates increased with temperature and decreased with increasing water saturation and depth, exhibiting the highest rates at 10 °C and 33% saturation at 5 cm depth (260 ± 60 pmol CH₄ gdw^-1 d^-1 ). Extrapolation of the CH₄ oxidation rates to the field yields net CH₄ uptake fluxes ranging from 11 to 73 μmol CH₄  m^-2 d^-1 , which are comparable to field measurements. Stable isotope mass balance indicates ~50% of the oxidized CH₄ is incorporated into the biomass regardless of temperature or saturation. Future atmospheric CH₄ uptake rates at AHI with increasing temperatures will be determined by the interplay of increasing CH₄ oxidation rates vs. water saturation and the depth to the water table during summer thaw.

Everybody's working for the weekend: changes in enjoyment of everyday activities across the retirement threshold

BACKGROUND

the aim of this study was to explore the associations between use of time and momentary hedonic affect ('enjoyment') in adults in the peri-retirement period.

METHODS

a total of 124 adults [61 males, 63 females; age 62 (4) years] completed a computerised use-of-time recall on 4 days at each of four time points (3-6 months pre-, 3, 6 and 12 months post-retirement), as well as surveys regarding self-reported health, well-being, sleep quality and loneliness. They reported how much they enjoyed each activity on a 0-10 scale. An individual Enjoyment Index was calculated as the time-weighted average of each participant's enjoyment ratings. Time-weighted enjoyment ratings were also calculated for nine mutually exclusive and exhaustive activity domains (Sleep, Chores, Work, Social, Screen Time, Self-care, Quiet Time, Transport, Physical Activity) and sub-domains.

RESULTS

the mean (±SD) Enjoyment Index was 7.43 ± 0.61, and was significantly and positively associated with well-being (P = 0.003 to P < 0.0001) and sleep quality (P = 0.03 to P < 0.0001), and negatively associated with loneliness (P = 0.003 to P < 0.0001). Mean Enjoyment Index values increased significantly (P < 0.0001) from pre-retirement (7.19 ± 0.82) to post-retirement (7.46 ± 0.89, 7.42 ± 0.91 and 7.49 ± 0.89 at 3, 6 and 12 months post-retirement). There were significant differences in enjoyment across domains, with Physical Activity (7.86 ± 1.11) and Social (7.66 ± 0.85) being the most enjoyable, and Work (7.10 ± 0.89) and Chores (7.09 ± 0.85) the least enjoyable.

CONCLUSION

enjoyment of everyday activities increased after retirement and remained elevated for at least 12 months. Work appears to constitute a relative hedonic deficit.

An active atmospheric methane sink in high Arctic mineral cryosols

Methane (CH4) emission by carbon-rich cryosols at the high latitudes in Northern Hemisphere has been studied extensively. In contrast, data on the CH4 emission potential of carbon-poor cryosols is limited, despite their spatial predominance. This work employs CH4 flux measurements in the field and under laboratory conditions to show that the mineral cryosols at Axel Heiberg Island in the Canadian high Arctic consistently consume atmospheric CH4. Omics analyses present the first molecular evidence of active atmospheric CH4-oxidizing bacteria (atmMOB) in permafrost-affected cryosols, with the prevalent atmMOB genotype in our acidic mineral cryosols being closely related to Upland Soil Cluster α. The atmospheric (atm) CH4 uptake at the study site increases with ground temperature between 0 °C and 18 °C. Consequently, the atm CH4 sink strength is predicted to increase by a factor of 5-30 as the Arctic warms by 5-15 °C over a century. We demonstrate that acidic mineral cryosols are a previously unrecognized potential of CH4 sink that requires further investigation to determine its potential impact on larger scales. This study also calls attention to the poleward distribution of atmMOB, as well as to the potential influence of microbial atm CH4 oxidation, in the context of regional CH4 flux models and global warming.

Endoscopic versus direct vision for saphenous vein graft harvesting in coronary artery bypass surgery

AIM

Recent reports have suggested harvesting of the greater saphenous vein for coronary artery bypass (CABG) using endoscopic techniques (endoscopic) results in early graft closure, higher rates of myocardial infarction (MI) and death. We explored the impact of this technique performed by experienced operators on postoperative morbidities, MI and death in our CABG patients.

METHODS

All non-emergent patients presenting for first time CABG surgery from 2006 to June 2009 were included. Data pertaining to surgery, readmissions, cardiac catheterization and interventions during long term follow-up were extracted from our local STS and ACC registries. Linear and logistic regressions with clinical covariates were conducted to determine if vein harvest technique group predicted the major outcomes. Propensity score matching (PSM) was completed to simulate randomization and improve covariate balance across the endoscopic and direct vision groups.

RESULTS

One thousand nine hundred and eighty-eight (N.=1988) patients were evaluated in this study (N.=1734 endoscopic group and N.=254 direct vision group). The perioperative major adverse outcomes (mortality within 30 days, stroke, reoperation for bleeding, prolonged ventilation and readmission within 30 days) were 17.8% in the endoscopic group and 25.2% in the direct vision group. The rate of leg infections was 0.3% for the endoscopic group and 1.6% for the direct vision group. After adjustment for covariates, the direct vision group had significantly greater risk for prolonged ventilation (P=0.03), MACE (P=0.02) and mortality within 30 days (P=0.01), but only marginally greater risk for leg infections (P=0.052). In the isolated CABG patients, operative death was 1% for the endoscopic group and 1.7% in the direct vision group (P=0.62). After PSM the endoscopic group was similar on all outcomes except for having fewer MACE (P=0.04). In a mean follow-up of 22.1±10.5 months, there were no significant differences in the overall rate and time to event for repeat revascularization, death and myocardial infarction. With maximum follow up of 39.6 months, 84 deaths were documented (N.=67 endoscopic and N.=17 direct vision).

CONCLUSION

The outcomes captured by the number of postoperative morbidities, incidence of myocardial infarction and/or the rate of death for the endoscopic technique were comparable to patients in whom the open techniques was used. There was a trend towards a decrease in leg infections with the use of the endoscopic device. Based on this study we consider the device safe and effective with experienced operators.

Evaluation of predicted network modules in yeast metabolism using NMR-based metabolite profiling

Genome-scale metabolic models promise important insights into cell function. However, the definition of pathways and functional network modules within these models, and in the biochemical literature in general, is often based on intuitive reasoning. Although mathematical methods have been proposed to identify modules, which are defined as groups of reactions with correlated fluxes, there is a need for experimental verification. We show here that multivariate statistical analysis of the NMR-derived intra- and extracellular metabolite profiles of single-gene deletion mutants in specific metabolic pathways in the yeast Saccharomyces cerevisiae identified outliers whose profiles were markedly different from those of the other mutants in their respective pathways. Application of flux coupling analysis to a metabolic model of this yeast showed that the deleted gene in an outlying mutant encoded an enzyme that was not part of the same functional network module as the other enzymes in the pathway. We suggest that metabolomic methods such as this, which do not require any knowledge of how a gene deletion might perturb the metabolic network, provide an empirical method for validating and ultimately refining the predicted network structure.

Genotypic and physiological characterization of Saccharomyces boulardii, the probiotic strain of Saccharomyces cerevisiae

Saccharomyces boulardii, a yeast that was isolated from fruit in Indochina, has been used as a remedy for diarrhea since 1950 and is now a commercially available treatment throughout Europe, Africa, and South America. Though initially classified as a separate species of Saccharomyces, recent publications have shown that the genome of S. boulardii is so similar to Saccharomyces cerevisiae that the two should be classified as conspecific. This raises the question of the distinguishing molecular and phenotypic characteristics present in S. boulardii that make it perform more effectively as a probiotic organism compared to other strains of S. cerevisiae. This investigation reports some of these distinguishing characteristics including enhanced ability for pseudohyphal switching upon nitrogen limitation and increased resistance to acidic pH. However, these differences did not correlate with increased adherence to epithelial cells or transit through mouse gut. Pertinent characteristics of the S. boulardii genome such as trisomy of chromosome IX, altered copy number of a number of individual genes, and sporulation deficiency have been revealed by comparative genome hybridization using oligonucleotide-based microarrays coupled with a rigorous statistical analysis. The contributions of the different genomic and phenotypic features of S. boulardii to its probiotic nature are discussed.

Speciation of copper in sewage effluents and its toxicity to Daphnia magna

Copper complexation capacity was determined in a range of sewage treatment works final effluents and receiving waters, upstream and downstream of the discharge point. Forty-eight-hour immobilization tests on Daphnia magna were used to assess the toxicity of copper in the effluent matrix. Complexation capacities in effluents were typically in the range 50 to 100 microg Cu/L, with higher values being found in the poorer-quality effluents with higher dissolved organic carbon (DOC) concentrations. The tolerance of Daphnia to dissolved copper concentrations was more than quadrupled in a 50% effluent matrix, with the increase in tolerance being related to complexation capacity. Ligand concentrations in effluents were found to correlate strongly with effluent DOC. No such relationship was observed in surface waters. On mixing with river water, sewage-derived ligands behaved conservatively and were relatively stable over time scales of up to 10 d.

Mandatory overtime: a necessary last resort

As I was asked to write an article on mandatory overtime, I thought, I'd rather not! This is one of those topics that no one wants to support; yet, some facilities have no other way of caring for their patients unless they employ mandatory overtime on an emergency basis. I then mentioned this opportunity to my CEO, Richard Young, and he commented, "It's a lot like asking pilots to continue to fly after their shift. Would we want to fly with that pilot?"