Main Determinants Research Articles

The effect of fixed capital formation rate on gross domestic product in Iraq

The total fixed capital formation is one of the main and influential determinants of production function through its impact on production costs, competitiveness, and profits. The Iraqi gross domestic product depends on one sector (the oil sector) in financing the government budget, which may lead to crises in case of oil price collapse. Therefore, the study aims to clarify the imbalance in the production function and the real output of the Iraqi economy and to indicate the role of the total fixed capital formation in this imbalance. The econometric methods were used to measure the degree of influence of the total fixed capital formation (independent variable) on the gross domestic product (dependent variable) from 2004 to 2020. The results showed a robust relationship between fixed capital formation and gross domestic product, where the independent variable affects the dependent variable by 4.5%, while the oil sector dominated the total value added by its acquisition of the total fixed capital formation by 47.45%, and the productive sectors of agriculture and industry achieved value added of 3.8%. The study concluded that the distribution of total capital formation by sector has an impact on the gross domestic product. Therefore, it is necessary to distribute the total fixed capital formation to the productive and production-supporting sectors to achieve economic growth and diversify the structure of the gross domestic product.

Prognostic determinants in patients with heart failure with reduced ejection fraction after a first hospitalisation for acute heart failure. COMFE registry

Abstract Introduction The clinical characteristics and determinants for prognosis of patients with a first hospitalisation for heart failure (HF) with reduced left ventricular ejection fraction (LVEF <40%) are poor described and show heterogeneous results that need major investigation. Purpose The aim of our study was to identify the clinical characteristics, prognosis and their main determinants in a prospective registry of patients with HF and reduced LVEF with a first hospital admission for acute heart failure, prognosis and their main determinants in a prospective registry in these patients. Methods We carried out a prospective registry in 2 University Hospitals of patients admitted to cardiology department due to first-time HF hospitalisation with reduced LVEF. 231 admitted consecutively between March 2021 and September 2022 were included, with a mean follow-up of 381 days. Continuous variables were represented as median (interquartile range) and categorical variables as percentage %. A multivariate logistic regression was performed in which age, sex, comorbidities, treatment, rhythm at discharge and improvement in LVEF were included; and using the Wald method, the predictors of rehospitalization and/or death were identified. Data were analysed using SPSS v. 25.0. Results The main baseline characteristics are shown in Table 1. The population had a median age of 71 years, 75% were men, with a high prevalence of arterial hypertension (HBP) (69%) and hyperlipidemia (57%). Quadruple therapy (Na-Glucose cotransporter 2 inhibitor [SGLT2i], Beta-Blocker, mineralocorticoid receptor antagonist [MRA] and angiotensin receptor-neprilysin inhibitor [ARNI], angiotensin converting enzyme inhibitor [ACEi] or Angiotensin-II receptor blocker [ARB]) was achieved in 57% at discharge. The dynamics of NTproBNP was studied from admission to completed up-titration, observing an average reduction of 37% and 32% met the criteria for improved LVEF after. The etiology is described in Figure 1a, with ischemic heart disease being the most represented (31%). Multivariate Cox regression for the combined event of readmission/death from any cause showed that treatment with SGLT2i (OR 0,48 [CI 95%: 0,23-0,98 p:0,04]) and Beta-Blocker (OR 0,35 [CI 95%: 0,14-0,87 p:0,02]) at discharge and improved LVEF (OR 0,33 [CI 95%: 0,15-0,72 p:0,006]) were protective predictors against the event; but diabetes mellitus (DM) was a predictor of a worse prognosis (OR 2,9 [CI 95%: 1,52-5,5 p:0,001]) Fig. 1b. Conclusions Patients with a first admission for HF with reduced LVEF constitute a heterogeneous clinical group. Improvement in LVEF after drug up-titration and treatment with SGLT2i and Beta-blocker are independently associated with a better prognosis. Our findings may have implications for their clinical management.Table 1Figure 1

The interplay of technology anxiety and digital health literacy in determining e-health readiness

Abstract Background The assessment of e-health readiness (eHR) is used to assess the ability of selected groups of citizens and patients, as well as society as a whole, to adopt e-health support. This study aimed to understand the main determinants of eHR in adult Internet users in Poland. Methods The analysis was conducted using data from a computer-based web-based interviewing (CAWI) survey carried out in June 2023 in a representative sample of 1661 Polish Internet users. The eHR score was established based on the e-Health Readiness Scale. Uni- (ULRM) and multivariable (MLRM) models were developed for eHR. Independent variables included technology anxiety (TA), digital health literacy (DHL), Internet (IU) and social media use (SMU), self-assessed health status, and sociodemographic variables. Results ULRMs revealed that TA, DHL, IU, SMU, an array of sociodemographic variables, and self-assessed health status (SAHS) were significant predictors of eHL. ULRMs with TA and DHL explained, respectively, 30.1% and 23.9% of the eHR variability. In MLRM developed with all predictors confirmed in ULRMs, only TA, DHL SMU, age, and income level maintained their significant effect on eHR. MLRM explained 42.8% of TA variability. Higher TA was associated with lower eHR (B, 95% confidentiality interval (95%CI): -0.30, -0.33 - -0.27). Respondents with higher DHL demonstrated higher eHR (B, 95%CI: 0.42, 0.37 - 0.48). Older persons were more likely to accept e-health solutions (B, 95%CI: 0.03, 0.003 - 0.05). More frequent SMU was associated with higher eHR (B, 95%CI: 1.87, 0.94 - 2.80). Finally, those who refused to reveal their level of income showed significantly lower eHR than those who revealed it (B, 95%CI: -0.84, -1.58 - -0.10). Conclusions TA and DHL are the main predictors of eHR. SMU also accounts for eHR. Unexpectedly, older age is a positive predictor of eHR. Finally, variables reflecting health status do not exert a significant effect on eHR. Key messages • Technology anxiety should be treated as an important determinant of the successful implementation of e health solutions. • The development of society’s digital health literacy may be a countermeasure to the unfavorable effect of technology anxiety on e-health readiness.

Vaccine conspiracy beliefs are the main determinant of adult vaccine hesitancy

Abstract Background Many factors influence the level of vaccine hesitancy. The COVID-19 pandemic demonstrated that conspiracy beliefs are an important element of overwhelming misinformation. The main aim of the study was to assess the relationship between vaccine hesitancy (VH) and vaccine conspiracy beliefs (VCB) in Polish society. Methods The analysis was conducted using data from an online survey of 2189 Internet users conducted in November 2021. Uni- (ULRM) and multivariable linear regression (MLRM) models were developed for vaccine hesitancy as a dependent variable. The independent variables included VCB score (VCBS), health (HL) and e-health literacy (eHL), Internet (IU) and social media use (SMU), political views (PV), and sociodemographic variables. Results The VCBS, eHL, HL, age, income, vocational and marital status, place of residence, PV, IU, and SMU were significant predictors of VH in ULRMs. A significant relationship with VH was maintained in MLRM for all independent variables enlisted earlier, apart from age, income, and vocational status. Respondents with higher VCBS were more likely to have higher VH (B, 95%CI: 0.38, 0.37-0.40). Those with undetermined HL had higher VH than persons with sufficient HL (B, 95%CI: 0.13, 0.06-0.20). A higher level of eHL predicted a lower level of VH (B, 95%CI: -0.01, -0.012 - -0.03). Lower IU and higher SMU were associated with higher VH (B, 95%CI: 0.16, 0.02-0.30, and 0.10, 0.03-0.17, respectively). Supporters of far right-wing party showed higher HV than supporters of the governmental party (B, 95%CI: 0.16, 0.07-0.27). Finally, singles showed higher HV than married (B, 95%CI: 0.07, 0.01-0.13), and residents of small cities had higher HV than residents of rural areas (B, 95%CI: 0.08, 0.004-0.15). Conclusions The vaccine conspiracy beliefs play a major role in the development of VH. The interventions aimed at the change of antivaccination attitudes should address the problem of widespread conspiracy beliefs. Key messages • Conspiracy beliefs are an important determinant of attitudes toward vaccination. • The development of adequate digital health literacy may be a protective factor against vaccine hesitancy.

Molecular mapping of KCNE4-dependent regulation of Kv1.3.

The voltage-gated potassium channel Kv1.3 plays a crucial role in the immune system response. In leukocytes, the channel is coexpressed with the dominant negative regulatory subunit KCNE4, which associates with Kv1.3 to trigger intracellular retention and accelerating C-type inactivation of the channel. Previous research has demonstrated that the main association between these proteins occurs through both C-termini. However, these data fail to fully elucidate the KCNE4-dependent modulation of channel kinetics. In the present study, we analyzed the contribution of each KCNE4 domain to the modulation of Kv1.3. Our results further confirmed that the C-terminus of KCNE4 is the main determinant involved in the association-triggered intracellular retention of the channel. Moreover, interactions throughout the transmembrane region were also observed. Both the C-terminus and, especially, the transmembrane domain of KCNE4 accentuated the C-type inactivation of Kv1.3. Our data provide, for the first time, the molecular effects that a KCNE peptide, such as KCNE4, exerts on a Shaker channel, such as Kv1.3. Our results pave the way for understanding the molecular mechanisms underlying potassium channel modulation and suggest that KCNE4 participates in the conformational rearrangement of the Kv1.3 architecture, altering the C-type inactivation of the channel.

Restoration of autophagy reduces diabetes-induced endothelial dysfunction

Abstract Introduction Diabetes leads to endothelial dysfunction, a main determinant of several cardiovascular diseases. The molecular mechanisms underlying the effects of hyperglycemia in endothelial cells are not fully characterized. Autophagy, the intracellular process by which the cell digests and recycles senescent or damaged cytoplasmic elements, exerts cardiovascular protective effects, limiting cardiac and vascular injury in the presence of stress. However, it is unclear how hyperglycemia modulates autophagy in endothelial cells. Purpose In this study, we elucidated the role of autophagy in vascular damage induced by diabetes. We also tested whether the restoration autophagy attenuates diabetes-induced endothelial damage. Methods We evaluated the effects of high-glucose (HG, 30 mM for 6 and 24 hours) on markers of endothelial function, autophagy, autophagic flux, and mitophagy in human umbilical endothelial cells (HUVEC) in vitro and in mesenteric arteries from wild-type mice (WT) ex vivo. We tested the effects of autophagy reactivation using the natural polyamine spermidine or ATG7 overexpression (ATG7ov) on apoptosis and angiogenesis in HUVEC treated with HG. Vascular reactivity experiments in the presence of autophagy activation were performed in HG-treated mouse mesenteric arteries and human saphenous veins from patients with peripheral artery disease. Finally, we evaluated the level of autophagy in the mammary arteries of newly discovered diabetic patients undergoing coronary artery bypass graft surgery. Results We found that HG reduces autophagy (0.6 fold p<0.05) and mitophagy (1.5 fold p<0.001) in HUVECs. We also demonstrated that endothelial cells undergoing hyperglycemia fail to activate autophagy under hypoxic conditions (0.6 fold p<0.05). Reactivation of autophagy by ATG7ov rescues apoptosis (0.52 fold p<0.05) and angiogenesis (2.3 fold p<0.05) in HUVEC treated with HG. We further observed that HG exacerbates endothelial dysfunction in a mouse model of genetic inhibition (Beclin 1 +/- mice), compared to WT mice (-19.16 % +-4.97 SEM vs -48.39 % +-2.18 SEM p<0.001). Mechanistically, HG increases cellular acetylation status (0.7 fold p<0.05) and activates p300 (1 fold p<0.05), an autophagy inhibitor. ATG7ov or spermidine, a p300 inhibitor, rescue endothelial-dependent relaxation in mesenteric arteries of WT mice treated with HG (ATG7ov -62.48 % +-5.16 SEM; SP -63.01 +-3.22 SEM; HG -40.67 % +-3.82 p<0.001). Finally, we observed reduced levels of autophagy in mammary arteries from diabetic patients and demonstrated that SP improves vascular function in human saphenous veins (-37.6 % +-12.76 SEM vs -12.52 % +-5.6 SEM p<0.001). Conclusion Our results suggest that the impairment of autophagy is a strong contributor of diabetes induced-endothelial dysfunction. Targeting autophagy may represent a valid therapeutic strategy to counteract the cardiovascular consequences of metabolic stress.

Sources and determinants of exposure to indoor air pollutants in schools and hospitals: a review

Abstract Background Indoor Air Quality (IAQ) is an important determinant of health. This study aimed to review the available scientific evidence about indoor pollutants and determinants of exposure in several settings, in the scope of the K-HEALTHinAIR project. Methods The systematic review was performed for the sources, concentrations, and determinants of pollutants in schools in the European region for 2013-2023. Articles were selected for data extraction if they were epidemiological studies, reported primary data for indoor air and pollutant levels, and, identified sources and determinants of exposure. Results The main pollutants affecting IAQ in schools and hospitals were carbon dioxide, volatile organic compounds (e.g., formaldehyde, terpenes), particulate matter, nitrogen dioxide, radon, ozone, and carbon monoxide. Besides the outdoor environment, several important indoor sources of emissions were identified such as occupancy, resuspension, cleaning products. Ventilation was the main determinant influencing the indoor levels of pollutants, stressing the importance of good planning, installation, and maintenance of mechanical ventilation systems in buildings. Other determinants were the number of occupants and their activities, and the building characteristics (e.g., type of floor, location, etc). Conclusions Results revealed indoor air quality as a public health concern since several pollutants are present in indoor settings. The identification of sources and determinants of exposure is fundamental for determining preventive measures in a public health perspective. Acknowledgments: K-HEALTHinAIR team for screening and data extraction: Mariana Corda, Jose Fermoso, Alicia Aguado, Sandra Rodriguez, Hanns Moshammer, Mireia Ferri, Belén Costa, Leticia Pérez, Wojciech Hanke, Artur Badyda, Piotr Kepa, Katarzyna Affek, Nina Doskocz, Laura Martín, Oguz Mulayim, Cesar Mediavilla Martinez, Alba Gómez, Ruben González, Isaac Cano, Josep Roca, Simon de Leede.

Reverse RV remodeling after isolated tricuspid valve surgery

Abstract Background Impact of tricuspid regurgitation (TR) on right ventricular (RV) and atrial (RA) size and function is one of the main determinants of prognosis. However, there is scarce data about the recovery of right chambers after isolated tricuspid valve surgery (ITVS). Purpose Our aim is to evaluate postsurgical changes in right chamber morphofunctional parameters by echocardiography after ITVS. Methods We selected all the patients that underwent ITVS in our tertiary centre between 2009 and 2022 excluding those with congenital anomalies. Echocardiographic right ventricular classical parameters (RV diameters, RA area, TAPSE and fractional area change (CAF)) as well as myocardial deformation (free wall (FW)- and 4 chambers (4C)- global longitudinal strain (GLS)) were compared in baseline studies, early and late postsurgical periods. Results Among the 45 patients included (65 ± 2 years-old, 51% female, TRI-SCORE 2 [1-4]) surgical indication was functional TR in 51%, 29% underwent tricuspid valve repair and 71% replacement. The treatment was considered ineffective (postoperative TR ≥ moderate) in 9%. In the early postsurgical phase (1.9 [1.2 – 3] months) a significant reduction in basal (-17%, p<0.01), mid (-15%, p<0.01) and longitudinal (- 7%, p<0,01) RV diameters as well as RA area (-26%, p<0.01) was noted. These changes persist in the late postoperative period for basal (-16%, p<0.01) and mid (-20%, p<0.01) RV diameters and RA area (-19%, p=0.03). RV function parameters suffer significant reduction in the early phases: TAPSE (-39%, p<0.01), FAC (-24%, p<0.01), FW-GLS (-17.1%, p<0.01) and 4C-GLS (-16.3%, p<0.01). In later stages the major worsening in classical parameters persist: TAPSE (-28%, p=0.01) y FAC (-20%. P=0.01). However, strain variables recover to the baseline values. Postoperative RV reverse remodeling is reflected in Table and Figure. Conclusions Postoperative changes in echocardiographic right chambers features after ITVS suggest that myocardial deformation parameters should be the method of choice for follow-up of this surgical procedure. Table. Comparison of baseline and postsurgical echocardiographic parameters. Figure. Echocardiographic parameters evolution.TableFigure

Results from the Swiss Cohort of Healthcare Professionals: Intention to stay and well-being

Abstract Background In the context of personnel shortages and high turnover rates in the healthcare sector, the Swiss COhort of Healthcare Professionals and Informal CAregivers (SCOHPICA) seeks to understand which factors act as determinants of professionals’ intent to stay in their profession and well-being, and to monitor their trajectories. Methods This cross-sectional study used baseline data from a prospective open cohort including any type of healthcare professionals practicing in Switzerland. They were invited to complete an online questionnaire measuring their intent to stay in their profession and well-being, several determinants of these, sociodemographic and socioprofessional characteristics, and they were able provide open comments. Standard statistical and thematic analyses were performed where appropriate. Results 5927 participants completed the 2022 (n = 1707) or 2023 (n = 4220) questionnaire, and 1811 left open comments. Preliminary results revealed that the main determinants of intention to stay and well-being were work-life balance, opportunities for development, and meaning of work. Moreover, nine sub-themes were identified in open comments, grouped under three main themes: 1) working hours and private life; 2) working conditions, relating to administrative work, salary, health and staffing issues, participants with a low intent to stay being overrepresented in the last two; 3) career paths, exploring employer changes or training recongnition. Conclusions Finding a balance between constraints inherent to the healthcare professions and professionals’ social life as well as reintroducing sense at work are key aspects that policymakers should take into account to brake turnover, retain healthcare professionals and make health professions attractive again. Key messages • Work-life balance, opportunities for development, and meaning of work appeared to be reasons to stay in healthcare professions. • People thinking of leaving commented on staffing and their own health.

Work context and drinking behavior in the French public service: a qualitative study

IntroductionAlcohol use disorders (AUD) are a major public health problem. Among the working population, alcohol is the most frequently used psychoactive substance, as well as the most inappropriately used. Alcohol consumption reduces the worker’s psychophysical integrity, leads to an increase in inappropriate behavior, accidents and injuries, and affects the safety and health of other workers. Thus, the workplace must play an essential role in prevention. Particularly in France, in the civil service, a specific professional sector made up of many professionals exposed to stress, the prevention of AUD must play an essential role. The objective of this study was to describe the framework of alcohol consumption in the French public service in order to understand the sources of alcohol consumption behaviors and to identify the prevention measures to be implemented, in order to reduce the risk of transition to an alcohol use disorder.MethodsThis descriptive qualitative study was based on focus groups. Sampling was purposive and data saturation was verified. Coding was “in vivo,” descriptive and pattern-oriented. Analysis was inductive thematic, and the COREQ guidelines were followed.ResultsFirstly, the presence of alcohol in the workplace has been characterized by a before-and-after a prohibition law, and by the revelation of mechanisms for avoiding the ban. Then, the three main determinants for alcohol use disorders were: society, work and personal factors. Lastly, the prevention initiatives identified must be based on both collective and individual approaches. They must be encouraged by the hierarchy, include screening, accompaniment to care, and take into account both work in the workplace and work at home. The fight against work-related alcohol use disorders must be part of the corporate culture.DiscussionPreventing alcohol-related disorders among civil servants will help fight the burden of non-communicable diseases.

Determinants of ICT Adoption in Business for Emerging SME Entrepreneurs in Indonesia

This study investigates the factors of ICT adoption by early-level small and medium-sized enterprises (SMEs) in Indonesia after the pandemic. The study was conducted among 237 new SME entrepreneurs from Indonesia's sixth-highest economic growth regions, with a confirmatory analysis of ICT adoption constructs in a structural equation model (SEM) analysis. This study showed that the benefits and integration with consumers are SMEs' main determinants when adopting ICT when starting their business. This condition is a rational response from SMEs when they begin their business in Indonesia's post-pandemic economic recovery conditions, which need to immediately emerge to capture the market with the efficiency and effectiveness of business processes. The study's results empirically provide a valid and reliable description of the determinants of ICT adoption for strengthening post-pandemic SME business practices and theoretically offer empirical evidence of factors for improving and strengthening digital transformation in business through usefulness and integration with consumers.

Structural barriers and facilitators to accessing HIV services for marginalized working populations: Insights from farm workers in South Africa.

Farm workers are a vulnerable working population that face significant inequalities in accessing health services, including those for HIV prevention, treatment, and care. This descriptive phenomenological study aimed to explore farm workers' experiences when accessing HIV services, and was conducted in Limpopo province, South Africa. Eighteen in-depth interviews (IDIs) were conducted in four health facilities from two districts, and two focus group discussions (FDGs) were conducted in one of the farms within the province. Purposive and systematic random sampling were used to select study participants. A deductive thematic approach was used to analyze data, informed by the social-ecological model of health. The results reveal that farm workers perceive multiple interdependent factors that inhibit or enable their access to HIV healthcare services. Key barriers to HIV healthcare were transport affordability, health worker attitudes, stigma and discrimination, models of HIV healthcare delivery, geographic location of health facilities, and difficult working conditions. Key facilitators to HIV healthcare included the availability of mobile health services, the presence of community health workers, and a supportive work environment. The findings suggest disparities in farm workers' access to HIV services, with work being the main determinant of access. We, therefore, recommend a review of HIV policies and programs for the agricultural sector, and models of HIV healthcare delivery that address the unique needs of farm workers.

CYP3A4*1B but Not CYP3A5*3 as Determinant of Long-Term Tacrolimus Dose Requirements in Spanish Solid Organ Transplant Patients.

Tacrolimus (TAC) is a commonly used immunosuppressive drug in solid organ transplantation. Pharmacogenetics has been demonstrated before to be decisive in TAC pharmacotherapy. The CYP3A5*3 variant has been reported to be the main determinant of TAC dose requirements; however, other polymorphisms have also proven to be influential, especially in CYP3A5 non-expressor patients. The aim of this study is to evaluate the influence of genetic polymorphisms in TAC therapy in a cohort of Spanish transplant recipients. Genetic analysis including ten polymorphic variants was performed, and demographic and clinical data and pharmacotherapy of 26 patients were analyzed. No significant differences were found in weight-adjusted dose between CYP3A5 expressors and non-expressors (0.047 mg/kg vs. 0.044 mg/kg), while they were found for carriers of the CYP3A4*1B allele (0.101 mg/kg; p < 0.05). The results showed that patients with at least one CYP3A4*1B allele had a higher TAC dose and lower blood concentration. Dose-adjusted TAC blood levels were also lower in CYP3A4*1B carriers compared to non-carriers (0.72 ng/mL/mg vs. 2.88 ng/mL/mg). These results support the independence of CYP3A5*3 and CYP3A4*1B variants as determinants of dose requirements despite the linkage disequilibrium present between the two. The variability in genotype frequency between ethnicities may be responsible for the discrepancy found between studies.

Greenwashing practices and ESG reporting: an international review

PurposeThis study provides an overview of the numerous theoretical facets of greenwashing (GW) and their relationship with sustainability, social responsibility and sustainable development. This study highlights the actions of governments and international organizations in GW. It delves into the sins of GW and the various metrics used in the literature to measure them. It seeks to distinguish between sustainability reporting and GW practices by offering a critical perspective on GW.Design/methodology/approachThis study measures GW practices at the international level and compares them with the ESG disclosure score. The main determinants of GW are assessed by examining the impact of a set of variables on GW. The influence of various sources used to gather the data were assessed using multiple regression analysis.FindingsFactors such as protocols and conventions, media role and the strength of environmental policies have a considerable and positive impact on the occurrence of GW.Research limitations/implicationsOwing to the research method chosen for measuring variables such as GW scores, procedures for measuring GW in companies should be developed. Multicriteria modeling could be a suitable approach to address the sorting or portfolio approach.Originality/valueThis study provides a theoretical basis for examining GW from a business-economic standpoint. It presents various perspectives on GW, analyzes relevant theories and explores potential GW strategies. This study highlights the connection between GW and various factors, including the influence of conventions, role of the media and strength of environmental policies.

Physiological Challenges and Adaptations in Competitive Freediving

Competitive freediving is associated with extreme physiologic challenges due to the effects of apnea, submersion in water, and increased ambient pressure. There has nevertheless been a continued progression of world records across freediving disciplines in recent years, with breath-hold times exceeding 10 minutes, and reaching diving depths beyond 200 meters of seawater. The main physiological determinants of breath-hold endurance are the available oxygen stores, i.e., intrapulmonary gas volume, inspired gas concentration, and rate of oxygen consumption. Other factors such as psychological and inherent factors contribute to the individual tolerance to an increasing respiratory stimulus with prolonged breath-hold duration. A freediving athlete must be able to tolerate apnea to stay underwater long enough to reach great distance or depth and resurface safely. Elite freedivers exhibit somewhat remarkable physiological adaptations such as a more pronounced diving-response and hypercapnia tolerance compared to non-divers, as well as metabolic and cerebrovascular adaptations. To reach great depths, elite freedivers employ a breathing technique called glossophyryngeal insufflation (GI) that is enlarging the ratio of total lung capacity to residual volume, thus, mitigating risk of lung squeeze and increasing intrapulmonary gas volume, and thereby enhancing available oxygen stores. Pulmonary anatomy and physiology could not be accounted to restrict the breath-hold diving depths achieved by competitive athletes. However, the acutely increased intrapulmonary pressure during GI is transmitted to the pulmonary vasculature, thereby eliciting a right ventricular pressure overload, and left ventricular dysfunction that may augment hypotension and syncope during glossopharyngeal insufflation. Due to extreme diffusion gradients between alveolar pN2 and N2 pressures in the body tissues at great depth, N2 will be forced into blood and body tissues during descent, elevating risk of N2 narcosis and decompression illness during deep dives. Breath-hold training and preparation have been shown to enhance breath-hold performance. This review highlights recent data on the profound cardiovascular, respiratory, and gas exchange effects that are observed in competitive freedivers, and discusses possible adaptations and risks for humans.

Impact of caring for patients with polyhandicap on institutional health care workers’ quality of life: a cross-sectional and longitudinal evaluation

BackgroundProfound intellectual multiple disabilities or polyhandicap (PLH) is defined as a combination of profound mental retardation and serious motor deficits resulting in extreme dependence. Support for these patients is multidisciplinary, complex, and time-consuming. Thus, institutional health care workers (HCWs) face specific working conditions: frequent physical tasks, distressed families, and restricted feedback.ObjectivesWe aimed to identify determinants of quality of life (QoL) of HCWs and to study longitudinal evolution.MethodsThe study used data from the French cohort EVAL-PLH. The participants were institutional HCWs of persons with PLH (age ≥ 3 years at the time of inclusion; age at onset of cerebral lesion &amp;lt;3 years old). Two populations were used: (1) cross sectional study: the sample 1 includes the HCWs assessed at T2 (2020–2021); (2) longitudinal study: the sample 2 includes the HCWs assessed at both T1 (2015–2016) and T2 (2020–2021). The data collected included: sociodemographics, health status, professional variables, and psycho-comportemental aspects. QoL was assessed using WHOQOL-BREF which provides 4 scores.ResultsIn comparison with French norms, the physical and social scores of QoL were significantly lower while the psychological score was significantly higher for (i) the 223 HCWs (participation rate 62%) assessed at T2 and (ii) the 61 HCWs assessed at T1 and T2. The main factors modulating QoL were age, marital status, self-perceived financial difficulties, personal chronic disease, anxiety-mood disorders, nature of coping strategies, and burnout.ConclusionThis study confirms the mixed (negative and positive) impact of caring persons with PLH on the institutional HCWs’ QOL. Main determinants of the HCW’s QOL were: older age, single status, perceived financial difficulties, altered health status, burn out and coping strategies.Clinical trial registration number: NCT02400528.

Developing a specific model to exploring the determinant of individuals’ attitude toward forest conservation

IntroductionIn the context of forest conservation, individuals’ attitude can significantly influence their intentions and subsequent behaviors towards conserving forests. However, there is a research gap when it comes to understanding the determinants of individuals’ attitude towards forests conservation. To address this gap, the present study aimed to investigate the influence of variables associated with values from value-belief-norm theory, awareness of consequences, and ascription of responsibility from norm activation model on individuals’ attitudes as main determinant of behavior intention.MethodsThe Data of study was collected from a sample of 200 students from Behbahan University, Iran. through a questionnaire designed specifically for this purpose. The validity and reliability of questionnaire were confirmed. Structural equation modeling was employed to analyze the collected data.ResultsThe findings of the study revealed that the examined variables were able to describe 88.6% of the variance in individuals’ attitude towards forest conservation. Specifically, it was found that biospheric (ƛ= 0.097) and altruistic (ƛ= 0.385) values, ascription of responsibility (ƛ= 0.150), and awareness of consequences (ƛ= 0.380) had significant and positive effects on individuals’ attitude towards forest conservation. On the other hand, egoistic values exhibited a significant and negative impact (ƛ= –0.071) on individuals’ attitude.DiscussionThese research findings hold significant implications for planners and policymakers involved in forest conservation efforts. By understanding the factors that shape individuals’ conservation attitudes, decision-makers can develop targeted strategies and interventions to strengthen positive attitudes towards forest conservation. Given the positive influence of biospheric values and awareness of consequences, developing awareness-raising programs to enhance individuals’ environmental knowledge and the awareness of outcomes of their conservation actions can be considered as strategy to strengthen public’s attitude and improvement their participation in forest conservation projects.

A new normal? Streaming municipal assemblies on social media before, during and after the pandemic

This study aims at understanding the effects that the Covid-19 lockdowns had on the streaming of municipal assemblies via social media, whether those effects persisted after the pandemic, and what were the main determinants, motivations, and consequences of adopting that practice. To accomplish these goals, an exploratory mixed methods approach is used. Quantitative methods are used to assess the evolution of the number of municipalities streaming their assemblies and to identify determinants of adoption. Qualitative methods are used to capture the perception of relevant actors. Portugal is used as the case of study (308 municipalities). It was found that streaming of municipal assemblies was clearly triggered by the pandemic and the subsequent local elections, while being moderated by some of the factors that are known to be important for digital government development at the local level: demography, socioeconomic dynamism, citizen participation, and political environment. It was also found that streaming assemblies contributes to improve transparency, accountability, trust, proximity, and the public image of the bodies, albeit having no effect on the forms available for citizen participation. It also contributes to assembly members' interventions becoming more frequent, longer, targeted, and moderated. To the best of the authors knowledge, this is the first longitudinal study to address the streaming of municipal assemblies via social media.

Metabolic rate and foraging behaviour: a mechanistic link across body size and temperature gradients

The mechanistic link between metabolic rate and foraging behaviour is a crucial aspect of several energy‐based ecological theories. Despite its importance to ecology however, it remains unclear whether and how energy requirements and behavioural patterns are mechanistically connected. Here we aimed to assess how modes of behaviour, including cumulative space use, patch selection and time spent in an experimental resource‐patchy environment, are related to a forager's standard metabolic rate (SMR) and its main determinants, i.e. body mass and temperature. We tested the individual behavioural patterns and metabolic rates of a model organism, the amphipod Gammarus insensibilis, across a range of body masses and temperatures. We demonstrated quantitatively that body mass and temperature exert a major influence on foraging decisions and space use behaviour via their effects on metabolic rates and the marginal value of energy. Individual cumulative space use was found to scale allometrically with body mass and exponentially with temperature, with patch giving‐up time falling as body mass and temperature increased. In response to warmer temperatures, the specimens adaptively intensified their foraging effort and explored larger spaces to offset the elevated SMR. Our results showed that SMR explained more variation than body mass and temperature combined, and had greater predictive power for behavioural patterns. Furthermore, foraging decisions regarding patch choice and partitioning were strongly related to mass‐and‐temperature‐adjusted SMR (residual), which is a component of metabolic phenotype. Individuals with higher M–T adjusted SMR initially preferred the most profitable patch and, as time progressed, abandoned the patch earlier and explored more space than the others. These results demonstrate that foraging decisions are intimately associated with variations in standard metabolic rate, whether phenotypic or due to size and temperature combined. This, in turn, sheds light on higher‐order energy‐based ecological processes.

Determinants of experiences and perceptions of corruption: A case study of Russian regions

In this article, the main determinants of experiences and perceptions of corruption in the Russian regions are analyzed. The research focuses on evaluating the determinants of corruption among ordinary people and business representatives in three regions of Russia. The main objectives of the research are: to reveal the relationship of individual characteristics and attitudes toward corruption with citizens’ actual experiences and perceptions of corruption; to learn how experiences and perceptions of corruption influence each other. The main conclusion is that the experience of corruption and its perception are interrelated. Those members of both the general public and the business community who perceive the prevalence of corruption to be high report experiencing corrupt practices more often than those who see a lower frequency of corruption. People who justify corruption are more likely to report encountering bribery and other low-level corruption practices. For business corruption, tolerance of corruption shows a significant link with perception of corruption, but not with real experiences of corruption. Social learning theory and victimization theory can explain the interdependence of perceptions and experiences of corruption in the Russian regions. The indicators of both perception and experience of corruption in the research can be used as indirect measures of corruption. Their interrelation in the same survey may also indicate their validity as instruments for measuring corruption.