Physical Risk Research Articles

Cardiovascular mortality in patients with atrial fibrillation and physical activity intensity: delineating the threshold of vigorous activity

Abstract Background/Introduction There is a correlation between light-to-moderate physical activity and reduced atrial fibrillation (AF) incidence and cardiovascular risk. Vigorous activities reduced the benefits and increased the risk of AF. The exact threshold at which physical activity increases the risk of cardiovascular death (CVD) in patients with AF remains to be determined. Purpose To determine the threshold of vigorous activity in patients with AF. Methods In this study, data from 23856 individuals from the Taiwan Biobank (2017) were analyzed. Physical activity levels were quantified in metabolic equivalent task (MET) hours/week and categorized into four groups based on 20 MET-hour increments. The study employed Kaplan-Meier survival analysis and an adjusted generalized additive model (GAM) to assess the impact of physical activity on CVD risk (adjusting for age, sex, diabetes, hypertension, chronic obstructive pulmonary disease, and chronic kidney disease), with follow-up data from 2017 to 2022. Results Over a median 5.51-year follow-up, 238 AF cases (cumulative rate of AF: 0.998%) were identified (48.7% female, mean age 61.7 years). The linear model indicated a lower CVD risk in participants engaging in moderate physical activity (20-40 MET-hours/week; adjusted hazard ratio [HR]: 0.38, 95% CI: 0.16-0.95) compared to the reference group (0-20 MET-hours/week). Notably, the GAM model demonstrated a significant increase in CVD risk for activities exceeding 40 MET-hours/week after multivariable adjustment. Conclusions Physical activity levels and CVD risk in AF patients are correlated in a J-shaped manner. The CVD risk of AF decreased with mild to moderate physical activity. For AF patients, it establishes a critical threshold of 40 MET-hours/week beyond which there is an increased risk of CVD, thus clarifying safe physical activity limits.Figure 1:KM sruvival curveFigure 2:Smooth model of GAM

Patient informed consent, ethical and legal considerations in the context of digital vulnerability with smart, cardiac implantable electronic devices.

Advancements in digitalisation with cardiac implantable electronic devices (CIEDs) allow patients opportunities for improved autonomy, quality of life, and a potential increase in life expectancy. However, with the digital and functional practicalities of CIEDs, there exists also cyber safety issues with transferring wireless information. If a digital network were to be hacked, a CIED patient could experience both the loss of sensitive data and the loss of functional control of the CIED due to an unwelcome party. Moreover, if a CIED patient were to become victim of a cyber attack, which resulted in a serious or lethal event, and if this information were to become public, the trust in healthcare would be impacted and legal consequences could result. A cyber attack therefore poses not only a direct threat to the patient's health but also the confidentiality, integrity, and availability of the CIED, and these cyber threats could be considered "patient-targeted threats." Informed consent is a key component of ethical care, legally concordant practice, and promoting patient-as-partner therapeutic relationships [1]. To date, there are no standardised guidelines for listing cybersecurity risks within the informed consent or for discussing them during the consent process. Providers are responsible for adhering to the ethical principles of autonomy, beneficence, non-maleficence, and justice, both in medical practice generally and the informed consent process specifically. At present, the decision to include cybersecurity risks is mainly left to the provider's discretion, who may also have limited cyber risk information. Without effective and in-depth communication about all possible cybersecurity risks during the consent process, CIED patients can be left unaware of the privacy and physical risks they possess by carrying such a device. Therefore, cyber risk factors should be covered within the patients' informed consent and reviewed on an ongoing basis as new risk information becomes available. By including cyber risk information in the informed consent process, patients are given the autonomy to make the best-informed decision.

Physical activity and risk of workplace and commuting injuries: a cohort study.

Leisure-time physical activity (PA) has been hypothesized to reduce the likelihood of occupational injuries, but it is unclear whether this association varies between workplace and commuting injuries. The aim of this study was to examine the association between PA and risk of workplace and commuting injuries. Data were derived from the Finnish Public Sector study including 82 716 person-observations (48 116 participants). PA was requested repeatedly in four questionnaire surveys between 2000-2012. The average level of PA from two subsequent questionnaires was used to assess long-term PA. To obtain a 1-year incidence of injuries, participants were linked to occupational injury records from the national register. Logistic regression analysis with generalized estimating equations was used to examine the association between PA and injury risk. The analysis was adjusted for age, sex, education, work schedule, job demand, sleep difficulties, cardiovascular diseases, diabetes, and depression for workplace and commuting injuries, and workplace injuries were additionally adjusted for physical heaviness of an occupation and injury risk by occupation. Higher level of PA was associated with a lower risk of workplace injuries compared to inactive participants [odds ratio (OR) 0.85, 95% confidence interval (CI) 0.73-0.98]. This association was most marked in the ≥50-year-old age group (OR 0.78, 95% CI 0.64-0.99). No association between the PA and the risk for commuting injuries was observed. Higher PA is associated with lower risk of workplace injuries particularly among older employees.

Association between physical activity and risk of premenstrual syndrome among female college students: a systematic review and meta-analysis

BackgroundThis study aimed to analyze the relationship between physical activity and the risk of premenstrual syndrome among college students.MethodsEligible studies were searched from the PubMed, Web of Science, and Embase databases. The link between physical activity and the risk of premenstrual syndrome was evaluated using odds ratio (OR) and 95% confidence interval (CI). The heterogeneity of the included studies was tested and their sources were explored by subgroup analysis. A sensitivity analysis was performed to assess the effect of a single study on the pooled results. The included studies were evaluated for publication bias. Five moderate-quality studies were included in this meta-analysis.ResultsPhysical activity levels were negatively associated with risk of premenstrual syndrome among college students (OR [95%CI] = 1.46 [1.09, 1.96], P = .011). The pooled results were not influenced after being stratified by the study region and whether multi-factor correction was performed or not. Publication bias was not observed in the included studies.ConclusionA high level of physical activity is dramatically associated with a reduced risk of premenstrual syndrome among female college students.

Association of physical activity pattern and risk of Parkinson’s disease

Increasing evidence suggests an association between exercise duration and Parkinson’s disease. However, no high-quality prospective evidence exists confirming whether differences exist between the two modes of exercise, weekend warrior and equal distribution of exercise duration, and Parkinson’s risk. Hence, this study aimed to explore the association between different exercise patterns and Parkinson’s risk using exercise data from the UK Biobank. The study analyzed data from 89,400 UK Biobank participants without Parkinson’s disease. Exercise data were collected using the Axivity AX3 wrist-worn triaxial accelerometer. Participants were categorized into three groups: inactive, regularly active, and engaged in the weekend warrior (WW) pattern. The relationship between these exercise patterns and Parkinson’s risk was assessed using a multifactorial Cox model. During a mean follow-up of 12.32 years, 329 individuals developed Parkinson’s disease. In a multifactorial Cox model, using the World Health Organization–recommended threshold of 150 min of moderate-to-vigorous physical activity per week, both the active WW group [hazard ratio (HR) = 0.58; 95% confidence interval (CI) = 0.43–0.78; P < 0.001] and the active regular group (HR = 0.44; 95% CI = 0.34–0.57; P < 0.001) exhibited a lower risk of developing Parkinson’s disease compared with the inactive group. Further, no statistically significant difference was observed between the active WW and the active regular groups (HR = 0.77; 95% CI = 0.56–1.05; P = 0.099). In conclusion, in this cohort study, both the WW exercise pattern and an equal distribution of exercise hours were equally effective in reducing Parkinson’s risk.

An Attractive Target: Do Perceptions of Physical Attractiveness Shape Victimization Risks in Women’s Prisons?

ABSTRACT Emerging research suggests that physical attractiveness may yield outcomes beyond preferential treatment, such as increasing the vulnerability to victimization during adolescence. Despite growing awareness of individual and institutional victimization risk factors during incarceration, research has yet to consider the role of physical attractiveness. Drawing on survey data collected from 223 women across two Pennsylvania prisons, this article investigates whether perceptions of physical attractiveness operate as protective or risk factors for victimization experienced while incarcerated. Logistic regression results show a significant positive association between interviewer-assessed perceptions of physical attractiveness and incarcerated women’s self-reported resident-on-resident victimization. Dominance analysis results indicate that perceptions of physical attractiveness ranked nearly as high as histories of abuse in predicting incarcerated women’s risk of victimization. This study uncovers an unintended consequence of physical attractiveness for imprisoned women, demonstrating their heightened susceptibility to in-prison victimization.

Family quality of life of parents of children with intellectual disability: Do psychological stress and parental involvement matter?

Background: The psychological stress of parents and improving family quality of life (FQoL) are continuing concerns for families of children with intellectual disability. We need to identify further ways to reduce their stress and improve their FQoL in China. Method: Examine the interrelations between psychological stress, parental involvement, and FQoL for parents with intellectual disability in mainland China. 467 parents of children with intellectual disability completed instruments measuring variables. Structural equation modelling (SEM) was employed to examine the interrelations. Results: Psychological stress, directly and indirectly, influenced parental involvement in FQoL. Physical and mental response (PMR) and risk awareness (RA) had a positive direct effect on FQoL, and optimistic hope (OH) had a negative effect on FQoL. Conclusions: Psychological stress affects FQoL of parents with children with intellectual disability in complex ways. Policies should be developed to help parents with children with disability decrease stress and develop scientific parental involvement.

The Relationships Between the Perception of Physical and Economic Risks Measured Within the Road Environment and Within the Digital Environment and the Relationships Between Risk Perceptions Measured in Separate Environments

Risk perception may be measured in different, separate environments. For example, drivers and pedestrians assess the risks in the road environment and workers assess the risks in the workplace environment. The purpose of this study is to examine the relationships between the risks perceived in several different environments in order to examine whether separate environments – such as the workplace environment and the road environment – are perceived as distinct environments, and whether the knowledge gained by learning to assess risks in one environment can be transferred to a new one. This study found a relationship between measures of risk perception while driving and a while crossing a road. Another finding is that a relationship was observed between the perception of risks related to vaccines and those related to medication, and a relationship was also observed between measures of risk perception while browsing the Internet and while using social media. The relationships between the measures of risk perception while crossing a road and the measures of risk perception while hiking in nature or in the workplace are small, as are the relationships between health-related risks and stock market-related risks. These findings suggest that separate environments, such as the workplace environment and the natural environment, are perceived as distinct environments from the road environment, and that knowledge learned in one environment cannot be transferred and used when in the other environment.

Associations between Motor Competence, Physical Activity and Sedentary Behaviour among Early School-Aged Children in the SELMA Cohort Study.

Low motor competence (MC) has been associated with lower physical activity (PA) and long-term health risks in children. Less is known about sex-specific patterns and associations during early school age. The aim of this study was to explore how motor difficulties are associated with PA levels, screen time, and organised sports participation (OSP). Data from 479 children, seven years of age, participating in the Swedish Environmental, Longitudinal, Mother and child, Asthma, and allergy (SELMA) pregnancy cohort study were used. MC and activity-related outcomes were assessed with questionnaires answered by parents. Associations between MC and outcomes were evaluated using logistic regression models adjusted for sex, overweight, and parental education level. Sex differences were investigated with interaction analyses and in stratified models. Children with motor difficulties had the same level of PA as their peers, but more screen time and lower OSP. Compared with children with normal MC, boys with motor difficulties had lower rates of OSP, but girls did not. This indicates that the identification and compensatory support for motor difficulties for boys at an early age, as well as the development of inclusive leisure time activities, are of importance to facilitate health-promoting activities on equal terms.

Exploring the effects of information sources on consumers’ purchase intentions for electric vehicles: evidence from China

This study aims to explore the relationship between different electric vehicle (EV) information sources and consumers’ psychological perceptions and purchase intentions for EVs. Based on the survey data from 1,311 respondents in pilot cities, the analysis results show that authority and peer sources are positively associated with economic, psychological, and environmental benefits and negatively correlated with financial, performance, and physical safety risks. Moreover, media sources are positively associated with the psychological and environmental benefits of EVs but negatively related to performance and physical safety risks. Beyond our expectation, media sources lack significant impact on financial risk and economic benefit. Furthermore, financial, performance, and physical safety risks are negatively associated with purchase intention; whereas psychological and economic benefits are positively related to purchase intention. Unfortunately, the relationship between environmental benefit and purchase intention has not been confirmed. Additionally, policy recommendations for the further promotion of EVs are discussed.

Firms’ borrowing costs and neighbors’ flood risk

AbstractThis study examines whether Italian firms exposed to physical climate risks incur additional borrowing costs due to spatial spillovers. Using a sample of 419,040 firm-year observations from 2016 to 2019, we find a positive relationship between a firm’s cost of debt and its neighborhood’s average exposure to climate risk. According to our findings, the costs associated with neighborhood climate risk are as relevant as those associated with a firm’s direct risk, with small businesses being the only ones affected by spillover effects. These results may be explained by small enterprises’ lack of financial diversification, poor bargaining power, and strong reliance on credit from financial intermediaries.

“Lace up Your Boots and Do Something:” A Symbolic‐Interactionist Analysis of Girls and Young Women Equestrian Athletes' Resilience

This analysis illuminates how girls and young women dedicated to horse sports craft a resilient identity that they take to their wider lives. The constitutive features of their horse person identity are their willingness to love, care, and learn about horses combined with their embodied close relationships with specific horses. This horse person identity orients them toward a resilient mindset marked by perseverance, patience, and adaptability, as they manage the physical and emotional risks inherent in riding. Significantly, they believe that their horse person‐derived resilient mindset is useful for challenges in personal relationships and social interactions outside their riding community.

Physical Activity, Sleep, and Risk of Late-Onset Severe Mental Illness: A Prospective Cohort Study From UK Biobank.

Previous studies have found that both physical inactivity and poor sleep are deleteriously associated with severe mental illness (SMI). The aim of current study was to investigate the joint association of physical activity (PA) and sleep with late-onset SMI (schizophrenia and bipolar disorder) risk. A total of 340187 (for schizophrenia)/340239 (for bipolar disorder) participants without schizophrenia or bipolar disorder from the UK Biobank were included. Baseline PA levels were categorized as high, intermediate, and low according to the total volume of PA. Sleep was categorized into healthy, intermediate, and poor according to an established composited sleep score of chronotype, sleep duration, insomnia, snoring, and daytime sleepiness. We derived 9 PA-sleep combinations, accordingly. After an average follow-up of 13.2 years, 814 participants experienced schizophrenia and 846 participants experienced bipolar disorder. Both low PA level, intermediate, and poor sleep were independently associated with increased risk of SMI. PA level and sleep had additive and multiplicative interactions on SMI risk. Compared to those with high PA level and healthy sleep, individuals with low PA and poor sleep had the highest risk of SMI (hazard ratio: 1.95; 95% CI: 1.02-3.70, P < .001) for schizophrenia; (hazard ratio: 3.81; 95% CI: 2.35-6.15) for bipolar disorder. A higher PA level may attenuate the detrimental effects of poor sleep. Both low PA and poor sleep was associated with increasing risk of late-onset SMI. Those with low PA and poor sleep had the highest risk of late-onset SMI, suggesting likely synergistic effects. Our findings supported the need to target both PA and sleep behaviors in research and clinical practice.

SAFE – A risk management tool to protect both people and pets in residential aged care facilities

Abstract Pet ownership has known health and well-being benefits for people of all ages. Most previous research on pet ownership among older people has focussed on older people with pets living independently in their own homes or the effects of visiting pet programs in residential aged care. With structural ageing of populations globally, the number of humans living into old age is increasing. Even with home support and care policies, an increasing number will need to live in communal aged care settings. Currently, pets rarely accompany older persons into communal residential aged care. This article presents a risk management tool – Safe Animal Friendly Environments (SAFE) – designed to facilitate and maintain private pet ownership among older people living in residential aged care facilities. SAFE was developed to identify best practice for both human and animal well-being in residential aged care. The tool supports both human and animal well-being during a human stage of life with many losses and pains while reducing the number of pet animals needlessly relinquished or even euthanised when owners need to ‘go into care’. It was developed using a Delphi process with multidisciplinary expert input. We identify the different types of risks for stakeholders (residents with pets, aged care facility staff and pets), including physical, zoonotic and psychological risks. None of the identified risks of pets in aged care are unmanageable. SAFE reduces risks to acceptable levels and directs how to remove them where possible. SAFE has a summative table listing 17 general risks: from animals to humans, humans to animals and animals to animals. Each identified risk has a pre-mitigation risk assessment (low, medium or high), recommended mitigation actions and a post-mitigation risk rating (low, medium or high). Post-mitigation risk is reduced to ‘low’ in almost all scenarios. SAFE has separate tables for dogs, cats, small mammals, birds and fish, each preceded by a best practice case study. The discussion links the Ottawa Charter for (human) health promotion and use of SAFE. SAFE contributes to the inclusion of residential aged care as a context for the personal human-animal bond.

Assessment Methodology for Physical Vulnerability of Vernacular Architecture in Areas Affected by Depopulation: The Case of Comunidad Valenciana, Spain

The intensity with which the phenomenon of depopulation has affected rural municipalities in Spain between 1950 and 2022 has led to a loss in the intergenerational transmission of traditional knowledge, values and customs. Sociocultural loss entails associated physical risks: the abandonment, demolition, and loss of vernacular architecture. This research analyzes the evolution of this type of architecture in a period of acute depopulation and its current state of conservation. A total of 180 case studies in the region of Comunidad Valenciana are analyzed through four factors affecting the physical vulnerability of dwellings: year of construction, state of conservation, type of use, and a combination of all three. Data management software is used to combine all the information and produce the results in a tabular and graphical format, while the Geographic Information System is used to draw up risk maps showing the results. These results are then divided into analysis groups created according to the degree of depopulation observed in the years mentioned. This made it possible to identify the relationship between depopulation and the conservation of vernacular architecture, showing the risk level for each case study, and thus creating an analysis methodology applicable in other territories affected by depopulation at a national and international level.

Assessing climate risk quantification tools – mere fulfilment of duty or actually beneficial?

PurposeThe study aims to assess the effectiveness of prevailing methods for quantifying physical climate risks. Its goal is to evaluate their utility in guiding financial decision-making within the real estate industry. Whilst climate risk has become a pivotal consideration in transaction and regulatory compliance, the existing tools for risk quantification frequently encounter criticism for their perceived lack of transparency and comparability.Design/methodology/approachWe utilise a sequential exploratory mixed-methods analysis to integrate qualitative aspects of underlying tool characteristics with quantitative result divergence. In our qualitative analysis, we conduct interviews with companies providing risk quantification tools. We task these providers with quantifying the physical risk of a fictive pan-European real estate portfolio. Our approach involves an in-depth comparative analysis, hypothesis tests and regression to discern patterns in the variability of the results.FindingsWe observe significant variations in the quantification of physical risk for the pan-European portfolio, indicating limited utility for decision-making. The results highlight that variability is influenced by both the location of assets and the hazard. Identified reasons for discrepancies include differences in regional databases and models, variations in downscaling and corresponding scope, disparities in the definition of scores and systematic uncertainties.Practical implicationsThe study assists market participants in comprehending both the quantification process and the implications associated with using tools for financial decision-making.Originality/valueTo our knowledge, this study presents the initial robust empirical evidence of variability in quantification outputs for physical risk within the real estate industry, coupled with an exploration of their underlying reasons.

Environmental health risks faced by operating room nurses: A descriptive study

BackgroundThere is limited research on the environmental risks faced by operating room nurses (ORNs). This prospective descriptive study aimed to identify the risk factors encountered by ORNs in their work environment. MethodsThe study included 139 ORNs working in six hospitals in southeastern Turkey. Data were collected between September 2019 and February 2020 through a questionnaire using the Occupational Risk Factors Scale and analyzed using SPSS 22.0 software. ResultsORNs reported varying types and rates of risks, including radiation, biological, ergonomic, chemical, psychological, and physical risks. Common risk factors included infection, radiation and chemical exposure, musculoskeletal issues from prolonged standing, exposure to extreme cold, and heavy workloads. Risk levels vary based on age, education, experience, certification, and work assignment. ConclusionsThese identified risk factors must be addressed by implementing national education programs focusing on factors influencing safety in ORs.

Ambitious efforts on residual emissions can reduce CO2 removal and lower peak temperatures in a net-zero future

Abstract Carbon dioxide removal (CDR) is expected to play a critical role in reaching net zero CO2 and especially net zero greenhouse gase (GHG) emissions. However, the extent to which the role of CDR in counterbalancing residual emissions can be reduced has not yet been fully quantified. Here, we use a state-of-the-art integrated assessment model to develop a ‘Maximum Sectoral Effort’ scenario which features global emissions policies alongside ambitious effort across sectors to reduce their gross GHG emissions and thereby the CDR required for offsets. We find that these efforts can reduce CDR by over 50% globally, increase both the relative and absolute role of the land sink in storing carbon, and more evenly distribute CDR contributions and associated side-effects across regions compared to CO2 pricing alone. Furthermore, the lower cumulative CO2 and nonCO2 emissions leads to earlier and lower peak temperatures. Emphasizing reductions in gross, in addition to net emissions while disallowing the substitution of less durable CDR for offsets can therefore reduce both physical and transition risks associated with high CDR deployment and temperature overshoot.

Nursing assessment of mental health issues in the general clinical environment: A descriptive study.

To evaluate the effectiveness of a mental health screening form for early identification and care escalation of mental health issues in general settings. A secondary aim was to explore general nurses' use of the form and their confidence to discuss mental health issues with patients. A cross-sectional design comprising a review of clinical records to determine use of the form, instances of missed care and escalation to the mental health team. The survey focused on nurses' confidence in general settings to engage in discussions with patients about mental health. Data were collected from April to December 2022. The Strengthening the Reporting of Observational Studies in Epidemiology Statement guided this study. Of 400 patient records, 397 were analysed; 293 (73.8%) of those had mental health screening by nurses. Age was a significant factor, with younger patients more likely to be screened although concerns were typically recognized in older patients. Of the 20 patients identified with mental health concerns, 9 (45%) were referred for further evaluation by the Clinical Liaison Team. While nurses were proactive in assessing physical risks, assessing risk factors that required deeper conversations with patients, including psychiatric history, was lacking. The survey highlighted fewer than half of the respondents (46%, n = 10) felt competent to engage in discussions about mental health; however, most (59%, n = 13) knew when to seek a mental health referral. General nurses have a role in the early identification and referral of patients with mental health challenges. However, training is imperative to facilitate deeper patient interactions concerning mental health. Integrating mental health checks within general settings is crucial for early detection and intervention, aligning with global quality care standards. STROBE guidelines. We received feedback that shaped the research protocol from a consumer representative.

A text mining analysis of European banks' and insurers' disclosures on climate‐related risks

AbstractThis paper empirically analyzes sustainability‐related disclosures of listed European banks and insurance companies by focusing on transition risks, physical risks as well as stranded assets as a possible consequence of transition and physical risks. We employ a text mining analysis and apply a comprehensive keyword catalog to 142 firms. The dataset used for the analysis comprises 852 annual and 551 sustainability reports, covering a sample period from 2017 to 2022. Our results show that disclosure on climate‐related risks considerably increases over the examined period, but that reporting on stranded assets is still in early stages. Moreover, European insurers report more on climate‐related risks relative to the number of analyzed tokens than banks. Finally, statistical evidence suggests that larger banks and insurers with above‐median market capitalization exhibit significantly more word hits on climate‐related risks as compared to smaller firms.