High Frequency Of Contact Research Articles

Spatio-temporal patterns of the COVID-19 pandemic, and place-based influential factors at the neighborhood scale in Tehran

Since its emergence in late 2019, the COVID-19 pandemic has attracted the attention of researchers in various fields, including urban planning and design. However, the spreading patterns of the disease in cities are still not clear. Historically, preventing and controlling pandemics in cities has always been challenging due to various factors such as higher population density, higher mobility of people, and higher contact frequency. To shed more light on the spread patterns of the pandemic, in this study we analyze 43,000 confirmed COVID-19 cases at the neighborhood level in Tehran, the capital of Iran. To examine spatio-temporal patterns and place-based factors contributing to the spread of the pandemic, we used exploratory spatial data analysis and spatial regression. We developed a geo-referenced database composed of 12 quantitative place-based variables related to physical attributes, land use and public transportation facilities, and demographic status. We also used the geographically weighted regression model for the local examination of spatial non-stationarity. According to the results, population density (R2 = 0.88) and distribution of neighborhood centers (R2 = 0.59), drugstores (R2 = 0.64), and chain stores (R2 = 0.59) are the main factors contributing to the spread of the disease. Additionally, density of public transportation facilities showed a varying degree of contribution. Overall, our findings suggest that demographic composition and major neighborhood-level physical attributes are important factors explaining high rates of infection and mortality. Results contribute to gaining a better understanding of the role of place-based attributes that may contribute to the spread of the pandemic and can inform actions aimed at achieving Sustainable Development Goals, particularly Goals 3 and 11.

Social Contact with Family and Non-Family Members Differentially Affects Physical Activity: A Parallel Latent Growth Curve Modeling Approach

Background: Social contact leads to an increased likelihood of engaging in physical activity (PA). However, the influence of social contact on PA would be different depending on the social contact source. This study aimed to identify the association of changes in social contact with family and non-family members with the change in PA using a parallel latent growth curve modeling. Methods: Participants were randomly selected from among residents in the study area age ≥ 20 years (n = 7000). We conducted mail surveys in 2014, 2016, and 2019. The 1365 participants completed all surveys. PA was assessed with validated single-item physical activity measure. Social contact was assessed by summing frequencies of face-to-face and non-face-to-face contacts with family/relatives not living with the participant and friends/neighbors. Parallel latent growth curve modeling was used to assess the cross-sectional, prospective, and parallel associations of social contact with PA change. Results: There was a positive cross-sectional association between contact with friends/neighbors and PA, whereas prospective and parallel associations between contact with family/relatives and PA. Conclusion: Contacting friends/neighbors did not predict the change in PA, and a high frequency of contact with family/relatives at baseline and increasing contact with family/relatives was associated with increased PA over 5-year.

Antecedents and mediating role of IT service climate in IT service quality: A mixed methods study

Developing a strong and positive information technology (IT) service climate is important to ensure high-quality IT services. The influence of job resources and personal resources on the IT service climate and the mediating effect of the IT service climate on IT service quality were explored in this study qualitatively and quantitatively. Among the various job resource factors, we found that training, reward, and information system (IS) support can improve the IT service climate. Coworker support shows a non-significant effect on IT service climate. Among the personal resource factors, self-efficacy and hope have significantly positive effects on the IT service climate. Optimism and resilience do not appear to significantly affect the IT service climate. Our results confirm that the IT service climate is an important mediator in enabling certain antecedents to properly impact IT service quality. The IT service climate was found to fully mediate the effects of training, reward, IS support, and hope while partially mediating the effect of self-efficacy. The effect of the IT service climate on IT service quality is also strengthened by a high customer contact frequency. The results presented here may provide scholars and practitioners with a comprehensive, workable understanding of the IT service climate.

Association Between Social Network and Physical Function in Community-Dwelling Older Adults in Japan.

A poor social network and the decline of physical function are known to be critical risk factors for functional decline in older adults. The aim of this study was to investigate the relationships between social network and physical function in Japanese community-dwelling older adults. Participants were 339 adults aged 65 years or older (mean age : 73.0 years, women :70.2%), living independently in their communities. A self-reported questionnaire was used to assess social network on two different scales-the 6-item Lubben Social Network Scale (6LSNS) and frequency of contact with other people. Handgrip strength, knee extension strength, gait speed, Timed Up and Go Test (TUG) results, and 5-repetition chair stand test (CST) scores were used to determine physical function. A multiple regression analysis that adjusted for confounding factors was used to analyze the relationship between the social network scales and each physical function test. According to the results of a multiple regression analysis, a high 6LSNS score was significantly associated with greater handgrip strength (B = 0.63, p = 0.03), faster CST (B = -0.23, p = 0.01), and faster TUG (B = -0.12, p = 0.03), and high frequency of contact was significantly associated with greater handgrip strength (B = 1.08, p = 0.01). Social network was associated with muscle strength and physical performance. Consequently, older adults with poor social networks require an assessment of physical function, since their physical functions have possibly deteriorated.

Gender and Age Differences in Loneliness: Evidence for People without and with Disabilities.

This study examines the relationships between loneliness, gender, and age for people without and with disabilities (moderate versus severe) in Germany. Using data taken from the German Socio-Economic Panel (SOEP) for the years 2013 and 2017 and using the UCLA (University of California, Los Angeles) Loneliness Scale, in general we found that males report lower loneliness scores as compared to those for females. Furthermore, we found a strong association between loneliness and the individual’s age, but with differences according to gender and disability status. For example, for males with severe disabilities levels of loneliness decrease with age, whereas for females with severe disabilities the opposite result is found. In addition, we found that participation in leisure activities and having a higher frequency of contacts with family, friends, and social online networks (measured by the relational time index) contribute to reducing loneliness for all individuals. From a public policy perspective, it is necessary to undertake the design, promotion, and implementation of instrumental, emotional, and social support measures for people with disabilities (in particular for females that are severely limited in their daily activities), which can contribute to reducing their loneliness scores and increasing their levels of life satisfaction.

An Empirical Study of The Effect of Urban Street Park on Park Users’ Mood

Urban street park is an important part of the urban park system, and also a kind of park with high contact frequency in people’s daily life, so it has potential promoting effect on people’s mental health. In order to test the effect of urban street park on the mood state of park users, this study took a street garden in Hefei of China as the research site and used stratified sampling method to carry out a questionnaire survey on park users visiting the park at different time periods. One way ANOVA results show that there is a significant difference in the mood changing scores among park users in the different groups of the satisfaction of the environment of the green landscape space, the resting space and the fitness space. Regression analysis results show that the park users’ satisfaction with the environment of the green landscape space and the resting space and the time spent in the park are positively correlated with their mood changes, indicating that the better quality of the environment of the green landscape space and the resting place of the park, the longer the park users staying in the park, the more positive effect of the park environment on users’ mood state. The conclusion provides a scientific basis for the related research on the mental health effects of urban parks.

Patterns of Primary Care Use Prior to a First Diagnosis of Nonaffective Psychotic Disorder in Ontario, Canada: Modèles d'utilisation des soins de première ligne avant un premier diagnostic de trouble psychotique non affectif en Ontario, Canada.

Many people experience early signs and symptoms before the onset of psychotic disorder, suggesting that there may be help-seeking prior to first diagnosis. The family physician has been found to play a key role in pathways to care. This study examined patterns of primary care use preceding a first diagnosis of psychotic disorder. We used health administrative data from Ontario (Canada) to construct a population-based retrospective cohort. We investigated patterns of primary care use, including frequency and timing of contacts, in the 6 years prior to a first diagnosis of psychosis, relative to a general population comparison group matched on age, sex, geographic area, and index date. We used latent class growth modeling to identify distinct trajectories of primary care service use, and associated factors, preceding the first diagnosis. People with early psychosis contacted primary care over twice as frequently in the 6 years preceding first diagnosis (RR = 2.22; 95% CI, = 2.19 to 2.25), relative to the general population, with a sharp increase in contacts 10 months prior to diagnosis. They had higher contact frequency across nearly all diagnostic codes, including mental health, physical health, and preventative health. We identified 3 distinct service use trajectories: low-, medium-, and high-increasing usage. We found elevated patterns of primary care service use prior to first diagnosis of psychotic disorder, suggesting that initiatives to support family physicians in their role on the pathway to care are warranted. Earlier intervention has implications for improved social, educational, and professional development in young people with first-episode psychosis.

Differences in Comorbid Conditions Among Older Adult Participants in Cardiac Rehabilitation.

Most older adults eligible for cardiac rehabilitation (CR) do not participate or participate with low frequency, although it is a standard of care for patients with cardiovascular disease (CVD). Identifying the barriers to older adult participation is key in improving CR efficacy. A range of patient characteristics was analyzed in relation to on-site frequency of participation in a CR program by older adult patients. These characteristics included demographics and indications for referral, as well as CVD and non-CVD diagnoses. The prevalence of these characteristics was compared among three patient cohorts, ranging from high contact frequency to minimal contact frequency of on-site participation in CR. Among the three participation frequency cohorts, no differences were noted in demographic factors, indications for referral, or CVD diagnoses. However, patients with hearing impairment (OR = 4.15: 95% CI, 1.32-13.08) or visual impairment (OR = 4.11: 95% CI, 1.46-11.59) at time of enrollment were more likely to be found in the minimal contact cohorts than the moderate or high contact frequency cohorts. Whereas differences in CVD had little bearing on frequency of CR participation in older patients, differences in hearing and visual impairment varied significantly. Patients with hearing and vision impairments attended less frequently. Sensory impairment has previously been demonstrated to impact health care utilization by older adults, but is rarely considered in the treatment of CVD or CR. As sensory impairments are extremely prevalent among geriatric patients, further study of these potential barriers to care might open possibilities for older adult participation in CR.

Boosting Perceived Customer Orientation as a Driver of Patient Satisfaction.

Several hospitals have embraced customer orientation as a strategy to better meet patients' needs, desires, and wishes. This study therefore investigates how hospitals can boost the extent to which patients feel treated in a customer-oriented way by staff (hereafter, "perceived customer orientation") and its implications for their satisfaction with the hospital. A cross-sectional study of hospital staff's interpersonal skills (interpersonal quality) and the atmosphere and physical features of the hospital (environmental quality) as drivers of perceived customer orientation and its satisfaction implications. Two hundred eighty-nine patients in seven surgery wards and two day-surgery departments of a Belgian hospital. Perceived customer orientation and patient satisfaction. Our results show that interpersonal and environmental qualities have a positive impact on perceived customer orientation, with the interpersonal skills of nursing staff having a greater effect than those of physicians. Perceived customer orientation, however, matters most for patient satisfaction when the nature of the service involves high-contact frequency. Interpersonal and environmental qualities may help to ensure that patients feel treated in a customer-oriented way, which improves patient satisfaction with the hospital.

Social relations and self-rated health in a multi-ethnic social housing area undergoing demolition

Abstract Background During the coming years, selected social housing areas in Denmark will undergo large structural changes as part of a political agenda. Previous studies on the effects of such interventions are inconclusive. Residential areas are important for the development of social relations and health. The aim of this study was to explore the associations between social relations and self-rated health (SRH) and the interaction with country of origin in an ethnically diverse social housing area undergoing demolition, and compare results with the municipality. Methods Data include multilingual interviewer driven surveys with residents aged 45+ years before demolition began in 2018 (N = 209) and during the demolition in 2019 (N = 132), and a health survey on municipality level (N = 1638). Information on social relations include contact frequency with and support from family, friends and neighbors. SRH was dichotomized into high/low. Descriptive and multivariate logistic regression analyses adjusted for age, sex and Western/non-Western origin are presented. Results In cross-sectional analyses from 2018, low contact frequency and low support increased the risk of low SRH, OR = 1.44 (0.63-3.29) and OR = 1.23 (0.62-2.48), especially when also having non-Western origin compared to having high contact frequency or support and Western origin, OR = 6.27 (1.80-21.84) and OR = 4.43 (1.68-11.69), respectively. The same association was seen in 2019 and on municipality level. Low contact frequency in 2018 was associated with higher risk of developing or maintaining low SRH in 2019 compared to the group with high contact frequency in 2018 in longitudinal analyses, OR = 3.04 (0.91-10.91). Conclusions Poor social relations increased the risk of low SRH, especially when also having non-Western origin. Having poor social relations before the demolition was associated with an increased risk of developing or maintaining low SRH during the demolition in an ethnically diverse social housing area. Key messages Having low contact frequency before area demolition in a social housing area in Denmark increased the risk of developing or maintaining low self-rated health after demolition had begun. Having poor social relations and non-Western origin is associated with a strong increased risk of low self-rated health in a deprived ethnic diverse social housing area in Denmark.

Typical case analysis of COVID-19 cluster epidemic in Shaanxi, 2020

Objective: By analyzed the transmission patterns of 4 out of the 51 COVID-19 cluster cases in Shaanxi province to provide evidences for the COVID-19 control and prevention. Methods: The epidemiological data of RT-PCR test-confirmed COVID-19 cases were collected. Transmission chain was drawn and the transmission process was analyzed. Results: Cluster case 1 contained 13 cases and was caused by a family of 5 who traveled by car to Wuhan and returned to Shaanxi. Cluster case 2 had 5cases and caused by initial patient who participated family get-together right after back from Wuhan while under incubation period. Cluster case 3 contained 10 cases and could be defined as nosocomial infection. Cluster case 4 contained 4 cases and occurred in work place. Conclusion: Higher contact frequency and smaller places were more likely to cause a small-scale COVID-19 cluster outbreak, with potential longer incubation period. COVID-19 control strategies should turn the attention to infection prevention and control in crowded places, management of enterprise resumption and prevention of nosocomial infection.

Assessment of knowledge, attitude and practices and the analysis of risk factors regarding schistosomiasis among fishermen and boatmen in the Dongting Lake Basin, the People\u2019s Republic of China

BackgroundFishermen and boatmen are a population at-risk for contracting schistosomiasis due to their high frequency of water contact in endemic areas of schistosomiasis in the People’s Republic of China (P. R. China). To develop specific interventions towards this population, the present study was designed to assess the knowledge, attitudes and practices (KAPs) towards schistosomiasis of fishermen and boatmen, and to identify the risk factors associated with schistosome infection using a molecular technique in a selected area of Hunan Province in P. R. China.MethodsA cross sectional survey was conducted in the Dongting Lake Basin of Yueyang County, Hunan Province. A total of 601 fishermen and boatmen were interviewed between October and November 2017. Information regarding sociodemographic details and KAPs towards schistosomiasis were collected using a standardized questionnaire. Fecal samples of participants were collected and tested by polymerase chain reaction (PCR). Logistic regression analysis was conducted to explore the risk factors related to the positive results of PCR.ResultsOf the 601 respondents, over 90% knew schistosomiasis and how the disease was contracted, the intermediate host of schistosomes and preventive methods. The majority of respondents had a positive attitude towards schistosomiasis prevention. However, only 6.66% (40/601) of respondents had installed a latrine on their boats, while 32.61% (196/601) of respondents defecated in the public toilets on shore. In addition, only 4.99% (30/601) respondents protected themselves while exposed to freshwater. The prevalence of schistosomiasis, as determined by PCR, among fishermen and boatmen in Yueyang County was 13.81% (83/601). Age, years of performing the current job, number of times receiving treatment, and whether they were treated in past three years were the main influencing factors of PCR results among this population.ConclusionsFishermen and boatmen are still at high risk of infection in P. R. China and gaps exist in KAPs towards schistosomiasis in this population group. Chemotherapy, and health education encouraging behavior change in combination with other integrated approaches to decrease the transmission risk in environments should be improved.

Modeling High-Order Chromatin Structure in Single Cells

Chromosome conformation capture techniques have discovered territorial organization of chromatin at an ensemble-averaged level. However, how chromatin folds at the single-cell level still remains elusive. Here, we introduce a self-returning random walk to describe the high-order structure of chromatin in single cells. Based on a simple folding algorithm, our model unifies the high contact frequency discovered by genomic techniques, and the high structural heterogeneity revealed by imaging techniques, which two chromatin properties we theoretically prove to be irreconcilable within a fractal polymer framework. Our model provides a holistic view of chromatin folding, in which the topologically associating domains are liquid-tree-like structures, linked and isolated by stretched out, transcriptionally active chromatin backbone to form a secondary structure of chromatin that further folds into a “3D forest” under confinement. Our theoretical predictions compare favorably with experimental observations of chromatin scaling and packing heterogeneity, which leads to the hypothesis that well-organized 3D structures such as domains and compartments are intrinsic chromatin characteristics at the single-cell level rather than merely statistical patterns of a large population. Based on a global folding parameter, the model reveals a unique structure-function relation that couples many chromatin structural properties under genomic response to environmental stress. Our results suggest the existence of universal folding principles for chromatin to fulfill its regulatory functions.

Chromosomal-level assembly of Juglans sigillata genome using Nanopore, BioNano, and Hi-C analysis.

Background Juglans sigillata, or iron walnut, belonging to the order Juglandales, is an economically important tree species in Asia, especially in the Yunnan province of China. However, little research has been conducted on J. sigillata at the molecular level, which hinders understanding of its evolution, speciation, and synthesis of secondary metabolites, as well as its wide adaptability to its plateau environment. To address these issues, a high-quality reference genome of J. sigillata would be useful.FindingsTo construct a high-quality reference genome for J. sigillata, we first generated 38.0 Gb short reads and 66.31 Gb long reads using Illumina and Nanopore sequencing platforms, respectively. The sequencing data were assembled into a 536.50-Mb genome assembly with a contig N50 length of 4.31 Mb. Additionally, we applied BioNano technology to identify contacts among contigs, which were then used to assemble contigs into scaffolds, resulting in a genome assembly with scaffold N50 length of 16.43 Mb and contig N50 length of 4.34 Mb. To obtain a chromosome-level genome assembly, we constructed 1 Hi-C library and sequenced 79.97 Gb raw reads using the Illumina HiSeq platform. We anchored ∼93% of the scaffold sequences into 16 chromosomes and evaluated the quality of our assembly using the high contact frequency heat map. Repetitive elements account for 50.06% of the genome, and 30,387 protein-coding genes were predicted from the genome, of which 99.8% have been functionally annotated. The genome-wide phylogenetic tree indicated an estimated divergence time between J. sigillata and Juglans regia of 49 million years ago on the basis of single-copy orthologous genes.ConclusionsWe provide the first chromosome-level genome for J. sigillata. It will lay a valuable foundation for future research on the genetic improvement of J. sigillata.

Оценка факторов риска развития рассеянного склероза в Республике Ингушетия

Currently the ubiquitous increase of multiple sclerosis (MS) prevalence is observed. The increase in number of patients with MS is marked also in the areas where MS prevalence was low previously, so the assessment of multiple sclerosis risk factors in populations with low multiple sclerosis risk is of a great value. There were no investigations of demyelinating disease epidemiology performed in the Republic of Ingushetia (RI) before. The purpose. To perform the clinical and epidemiological study of MS in RI; to study the factors, affecting the risk of MS development in RI population. Material and methods. We examined 73 patients (46 women and 27 men) with reliable MS (according to McDonald criteria, 2010, 2017). The investigation of risk factors of MS development was carried out by the method of analytical epidemiology «case-control». All respondents were inhabitants of RI, the pairs were comparable in age, gender and nationality. We studied serum concentration of vitamin D3 metabolite — 25(ОН)D3 by ELISA method. Results. Prevalence of NS in RI was 14.4 cases for 100 thousand of the population as of 1.01.2020. Among MS patients we revealed a higher frequency of contact with petrol and oil products (12 of 73 respondents vs 2 of 61 in groups of MS patients and control group respectively, р < 0,05), and paints (15 of 73 respondents vs 2 of 61 in groups of MS patients and control group respectively, р < 0,05), aged over 15 years old. Reliably more often than persons of control group MS patients have a case of surgical interventions, severe caries at the age over 15 years old (р < 0,05), head injury at any age (р < 0,05), tonsillitis, measles, rubella, parotitis occurred at the age before 7 years old (р < 0,05) and herpetic infection at any age (р < 0,05). According to the comparison of vitamin D3 metabolite — 25(ОН)D3 serum concentration parameters in MS patients of both sexes of RI population and control group we revealed a tendency to decrease of serum vitamin D level in MS patients; the differences in this feature in men with MS (15,15 (0,61) ng/ml) and men of control group (22,04 (8,0) ng/ml) were statistically reliable. Conclusion. The Republic of Ingushetia belongs to the areas of low-mild multiple sclerosis development risk, which is probably due to both demographic and geographical-climatic features. The external factors of MS development risk revealed in this research confirm the multifactor nature of the disease. Further investigations of the probable modifiability of these factors are of great importance.

Relationship between neighbourhood social participation and depression among older adults: A longitudinal study in China.

Previous research has found a negative linkage between neighbourhood social participation and depressive symptoms in Western countries, but the cross-sectional design of these studies limits the ability to infer causality. Little attention has been paid to socio-psychological pathways linking neighbourhood social participation to depressive symptoms among older adults in China. This study aimed to examine the impact of neighbourhood social participation on depressive symptoms among older adultsin China. It alsofurther explored the mediating roles of physical activity, social contact among neighbours, and contact with own children in the relationship between social participation and depressive symptoms. Data obtained through three waves (2011, 2013, and 2015) of the China Health and Retirement Longitudinal Study were used. The sample consisted of 10,105 individuals aged 60 and above and 24,623 person-year records captured during these three waves. Depressive symptoms were assessed using the Center for Epidemiology Studies of Depression scale. Results showed that respondents' depression decreased with an increasing level of neighbourhood social participation, more time spent on physical activities, and a higher frequency of contact with neighbours and with own children. These factors were found to partly mediate the relationship between neighbourhood social participation and depression. The negative relationships between social contact and depression and contact with own children and depression were both strengthened by neighbourhood social participation. In conclusion, physical activity, social contact among neighbours and contact with own children are mechanisms through which neighbourhood social participation lowers the risk of depression among older adults in China.

Analysis of the structural variability of topologically associated domains as revealed by Hi-C.

Three-dimensional chromosome structure plays an integral role in gene expression and regulation, replication timing, and other cellular processes. Topologically associated domains (TADs), building blocks of chromosome structure, are genomic regions with higher contact frequencies within the region than outside the region. A central question is the degree to which TADs are conserved or vary between conditions. We analyze 137 Hi-C samples from 9 studies under 3 measures to quantify the effects of various sources of biological and experimental variation. We observe significant variation in TAD sets between both non-replicate and replicate samples, and provide initial evidence that this variability does not come from genetic sequence differences. The effects of experimental protocol differences are also measured, demonstrating that samples can have protocol-specific structural changes, but that TADs are generally robust to lab-specific differences. This study represents a systematic quantification of key factors influencing comparisons of chromosome structure, suggesting significant variability and the potential for cell-type-specific structural features, which has previously not been systematically explored. The lack of observed influence of heredity and genetic differences on chromosome structure suggests that factors other than the genetic sequence are driving this structure, which plays an important role in human disease and cellular functioning.

The longitudinal association between social network composition and episodic memory in older adulthood: the importance of contact frequency with friends

Objectives: The composition of one’s social network has been associated with cognition such that a greater proportion of family is associated with worse cognition compared to a greater proportion of friends. It is not clear whether this association between network composition and cognitive aging is driven by potential negative effects of family interactions or positive effects of friend interactions.Methods: Using the Health and Retirement Study (T1: 2006/2008, T2: 2010/2012, T3: 2012/2014), a longitudinal mediation model was conducted to test the effects of composition on episodic memory and latent change in memory through contact frequency with friends and family.Results: Analyses revealed indirect effects of composition on both T2 memory and latent change in memory through contact frequency with friends. A greater proportion of family in one’s network was associated with lower contact frequency with friends and in turn lower memory. Composition was also associated with higher contact frequency with family; however, contact frequency with family was not associated with memory.Conclusions: These findings suggest that spending time with family may not affect episodic memory in older adulthood, but spending time with friends may be beneficial. Potential mechanisms and implications regarding the importance of friendships in later life are discussed.

An evidence-based approach to developing low-carbohydrate diets for type 2 diabetes management: A systematic review of interventions and methods.

To identify core diet and delivery components of low-carbohydrate (CHO) diets that have demonstrated efficacy for type 2 diabetes (T2D) management. MEDLINE, Pre-MEDLINE, EMBASE, CINAHL and the Cochrane Library of Controlled Trials databases were systematically searched from inception until August 18, 2018. Primary intervention studies of low-CHO diets (≤130 g/d or 26% total energy intake [TEI]) were included. Content analysis was performed on the low-CHO diet protocols classified as safe and effective for T2D management. A total of 41 studies published between 1963 and 2018 were included, of which 40 were classified as safe and effective for inclusion in the primary analysis. Thirteen studies (13/40) were on very-low-CHO diets (<50 g/d), 14/40 included low-CHO diets (≤130 g/d or 26% TEI), and 13/40 were adapted according to participant progress. Thirty-one studies reported a total energy prescription, of which 18/31 encouraged ad libitum intakes. Twenty studies reported a prescribed dietary fat amount, of which 18/20 were unrestricted or high-fat (>35% TEI). Twenty-six studies reported a prescribed dietary protein amount, of which 22 were unrestricted or were high-protein (>25% TEI). The types of dietary CHO, fat and protein recommended were predominantly whole foods. Common delivery methods reported were dietician and/or physician involvement, moderate to high frequency of contact (≥1 session/month) and use of participant self-monitoring. Multiple approaches for developing and delivering a low-CHO diet intervention for T2D management are safe and effective. A comprehensive set of core dietary components to consider in the formulation of low-CHO diet protocols were identified for use in clinical practice and to inform evidence-based guidelines for T2D management.

초등학생의 관광 영향 인식이 관광객에 대한 정서와 태도에 미치는 영향

This study examined the influence of elementary school children’s perception of tourism impact on affect and attitudes toward tourists. The research was conducted under the assumption that there will be differences in the 107perception of tourism impacts as well as affect and attitudes of tourists depending on the frequency level of contact with tourists. It was found that the high contact frequency group had lower perception scores of positive tourism impact than the low contact frequency group. In contrast, the high contact frequency group showed higher perception scores of negative tourism impact. Similarly, the high contact frequency group had lower positive affect scores and higher negative affect scores toward tourists than the low contact frequency group. The attitude toward tourists also showed similar results which the high contact frequency group with visitors had lower attitude scores than the low contact frequency group. These results suggest that schools, community and tourists need to work together for preventing emotional hurts by tourists. Second, it is suggested that efforts should be made to minimize the damage to the real life of the local residents.