| 1. |
- Neves, Ana Luisa, et al.
(författare)
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Determinants of the Use of Health and Fitness Mobile Apps by Patients With Asthma : Secondary Analysis of Observational Studies
- 2021
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Ingår i: Journal of Medical Internet Research. - : JMIR Publications. - 1438-8871. ; 23:9
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Tidskriftsartikel (refereegranskat)abstract
- Background: Health and fitness apps have potential benefits to improve self-management and disease control among patients with asthma. However, inconsistent use rates have been reported across studies, regions, and health systems. A better understanding of the characteristics of users and nonusers is critical to design solutions that are effectively integrated in patients' daily lives, and to ensure that these equitably reach out to different groups of patients, thus improving rather than entrenching health inequities. Objective: This study aimed to evaluate the use of general health and fitness apps by patients with asthma and to identify determinants of usage. Methods: A secondary analysis of the INSPIRERS observational studies was conducted using data from face-to-face visits. Patients with a diagnosis of asthma were included between November 2017 and August 2020. Individual-level data were collected, including age, gender, marital status, educational level, health status, presence of anxiety and depression, postcode, socioeconomic level, digital literacy, use of health services, and use of health and fitness apps. Multivariate logistic regression was used to model the probability of being a health and fitness app user. Statistical analysis was performed in R. Results: A total of 526 patients attended a face-to-face visit in the 49 recruiting centers and 514 had complete data. Most participants were <= 40 years old (66.4%), had at least 10 years of education (57.4%), and were in the 3 higher quintiles of the socioeconomic deprivation index (70.1%). The majority reported an overall good health status (visual analogue scale [VAS] score>70 in 93.1%) and the prevalence of anxiety and depression was 34.3% and 11.9%, respectively. The proportion of participants who reported using health and fitness mobile apps was 41.1% (n=211). Multivariate models revealed that single individuals and those with more than 10 years of education are more likely to use health and fitness mobile apps (adjusted odds ratio [aOR] 2.22, 95%CI 1.05-4.75 and aOR 1.95, 95%CI 1.12-3.45, respectively). Higher digital literacy scores were also associated with higher odds of being a user of health and fitness apps, with participants in the second, third, and fourth quartiles reporting aORs of 6.74 (95%CI 2.90-17.40), 10.30 (95%CI 4.28-27.56), and 11.52 (95%CI 4.78-30.87), respectively. Participants with depression symptoms had lower odds of using health and fitness apps (aOR 0.32, 95%CI 0.12-0.83). Conclusions: A better understanding of the barriers and enhancers of app use among patients with lower education, lower digital literacy, or depressive symptoms is key to design tailored interventions to ensure a sustained and equitable use of these technologies. Future studies should also assess users' general health-seeking behavior and their interest and concerns specifically about digital tools. These factors may impact both initial engagement and sustained use.
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| 2. |
- Stanaway, Jeffrey D., et al.
(författare)
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Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks for 195 countries and territories, 1990-2017: A systematic analysis for the Global Burden of Disease Study 2017
- 2018
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Ingår i: The Lancet. - 1474-547X .- 0140-6736. ; 392:10159, s. 1923-1994
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Tidskriftsartikel (refereegranskat)abstract
- Background The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017 comparative risk assessment (CRA) is a comprehensive approach to risk factor quantification that offers a useful tool for synthesising evidence on risks and risk-outcome associations. With each annual GBD study, we update the GBD CRA to incorporate improved methods, new risks and risk-outcome pairs, and new data on risk exposure levels and risk- outcome associations. Methods We used the CRA framework developed for previous iterations of GBD to estimate levels and trends in exposure, attributable deaths, and attributable disability-adjusted life-years (DALYs), by age group, sex, year, and location for 84 behavioural, environmental and occupational, and metabolic risks or groups of risks from 1990 to 2017. This study included 476 risk-outcome pairs that met the GBD study criteria for convincing or probable evidence of causation. We extracted relative risk and exposure estimates from 46 749 randomised controlled trials, cohort studies, household surveys, census data, satellite data, and other sources. We used statistical models to pool data, adjust for bias, and incorporate covariates. Using the counterfactual scenario of theoretical minimum risk exposure level (TMREL), we estimated the portion of deaths and DALYs that could be attributed to a given risk. We explored the relationship between development and risk exposure by modelling the relationship between the Socio-demographic Index (SDI) and risk-weighted exposure prevalence and estimated expected levels of exposure and risk-attributable burden by SDI. Finally, we explored temporal changes in risk-attributable DALYs by decomposing those changes into six main component drivers of change as follows: (1) population growth; (2) changes in population age structures; (3) changes in exposure to environmental and occupational risks; (4) changes in exposure to behavioural risks; (5) changes in exposure to metabolic risks; and (6) changes due to all other factors, approximated as the risk-deleted death and DALY rates, where the risk-deleted rate is the rate that would be observed had we reduced the exposure levels to the TMREL for all risk factors included in GBD 2017.
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| 3. |
- Amaral, Rita, et al.
(författare)
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Profiling Persistent Asthma Phenotypes in Adolescents : A Longitudinal Diagnostic Evaluation from the INSPIRERS Studies
- 2021
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Ingår i: International Journal of Environmental Research and Public Health. - : MDPI. - 1661-7827 .- 1660-4601. ; 18:3
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Tidskriftsartikel (refereegranskat)abstract
- We aimed to identify persistent asthma phenotypes among adolescents and to evaluate longitudinally asthma-related outcomes across phenotypes. Adolescents (13-17 years) from the prospective, observational, and multicenter INSPIRERS studies, conducted in Portugal and Spain, were included (n = 162). Latent class analysis was applied to demographic, environmental, and clinical variables, collected at a baseline medical visit. Longitudinal differences in clinical variables were assessed at a 4-month follow-up telephone contact (n = 128). Three classes/phenotypes of persistent asthma were identified. Adolescents in class 1 (n = 87) were highly symptomatic at baseline and presented the highest number of unscheduled healthcare visits per month and exacerbations per month, both at baseline and follow-up. Class 2 (n = 32) was characterized by female predominance, more frequent obesity, and uncontrolled upper/lower airways symptoms at baseline. At follow-up, there was a significant increase in the proportion of controlled lower airway symptoms (p < 0.001). Class 3 (n = 43) included mostly males with controlled lower airways symptoms; at follow-up, while keeping symptom control, there was a significant increase in exacerbations/month (p = 0.015). We have identified distinct phenotypes of persistent asthma in adolescents with different patterns in longitudinal asthma-related outcomes, supporting the importance of profiling asthma phenotypes in predicting disease outcomes that might inform targeted interventions and reduce future risk.
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| 4. |
- Jacome, Cristina, et al.
(författare)
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Monitoring Adherence to Asthma Inhalers Using the InspirerMundi App : Analysis of Real-World, Medium-Term Feasibility Studies
- 2021
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Ingår i: Frontiers in Medical Technology. - : Frontiers Media S.A.. - 2673-3129. ; 3
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Tidskriftsartikel (refereegranskat)abstract
- Background: Poor medication adherence is a major challenge in asthma and objective assessment of inhaler adherence is needed. InspirerMundi app aims to monitor inhaler adherence while turning it into a positive experience through gamification and social support.Objective: We assessed the medium-term feasibility of the InspirerMundi app to monitor inhaler adherence in real-world patients with persistent asthma (treated with daily inhaled medication). In addition, we attempted to identify the characteristics of the patients related to higher app use.Methods: Two real-world multicenter observational studies, with one initial face-to-face visit and a 4-month telephone interview, were conducted in 29 secondary care centers from Portugal. During an initial face-to-face visit, patients were invited to use the app daily to register their asthma medication intakes. A scheduled intake was considered taken when patients took a photo of the medication (inhaler, blister, or others) using the image-based medication detection tool. Medication adherence was calculated as the number of doses taken as a percentage of the number scheduled. Interacting with the app =30 days was used as the cut-off for higher app use.Results: A total of 114 patients {median 20 [percentile 25 to percentile 75 (P25-P75) 16-36] years, 62% adults} were invited, 107 (94%) installed the app and 83 (73%) completed the 4-month interview. Patients interacted with the app for a median of 18 [3-45] days, translated on a median use rate of 15 [3-38]%. Median inhaler adherence assessed through the app was 34 [4-73]% when considering all scheduled inhalations for the study period. Inhaler adherence assessed was not significantly correlated with self-reported estimates. Median adherence for oral and other medication was 41 [6-83]% and 43 [3-73]%, respectively. Patients with higher app use were slightly older (p = 0.012), more frequently taking medication for other health conditions (p = 0.040), and more frequently prescribed long-acting muscarinic antagonists (LAMA, p = 0.024). After 4 months, Control of Allergic Rhinitis and Asthma Test (CARAT) scores improved (p < 0.001), but no differences between patients interacting with the app for 30 days or less were seen.Conclusions: The InspirerMundi app was feasible to monitor inhaler adherence in patients with persistent asthma. The persistent use of this mHealth technology varies widely. A better understanding of characteristics related to higher app use is still needed before effectiveness studies are undertaken.
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| 5. |
- Kalantari, Zahra, et al.
(författare)
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URBANIZATION DEVELOPMENT UNDER CLIMATE CHANGE : HYDROLOGICAL RESPONSES IN A PERI-URBAN MEDITERRANEAN CATCHMENT
- 2017
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Ingår i: Land Degradation and Development. - : Wiley. - 1085-3278 .- 1099-145X. ; 28:7, s. 2207-2221
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Tidskriftsartikel (refereegranskat)abstract
- Relatively few studies have so far investigated the hydrological impacts of urbanization in Mediterranean catchments, and particularly in peri-urban catchments experiencing relatively rapid and large changes in their land-use mosaic. This study uses data-based model simulations to investigate such impacts, with the Ribeira dos Covoes catchment in Portugal as a concrete Mediterranean peri-urban catchment example. We distinguish the impacts of urbanization from those of climatic change on the water flux partitioning and connectivity in the catchment over the period 1958-2013. Decrease in precipitation over this period has primarily driven decreases in annual runoff and actual evapotranspiration, while the urbanization development has primarily changed the relative flux partitioning and connectivity pattern in the catchment. The relative contribution of overland flow to annual and seasonal runoff has increased, keeping the absolute overland flow more or less intact, while the baseflow contribution to the stream network has decreased. Methodologically, the present simulation approach provides a relevant means for distinguishing main drivers of change in hydrological flux partitioning and connectivity under concurrent urbanization and climatic changes.
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| 6. |
- Pinto, Luís Valença, et al.
(författare)
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Ecosystem services and well-being dimensions related to urban green spaces - A systematic review
- 2022
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Ingår i: Sustainable cities and society. - : Elsevier BV. - 2210-6707. ; 85
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Forskningsöversikt (refereegranskat)abstract
- Urban green spaces (UGS) supply several ecosystem services (ES) key to human wellbeing. In this article, we conducted a systematic review focused on identifying UGS's ES and wellbeing dimensions. From the 3626 articles screened, 218 were used in this review. Most studies were conducted in Europe, China, the United States of America (USA) and South Africa. Among all UGS, parks and gardens were the most investigated, with less of a focus on urban trees, forests, coastal mangroves, golf courses, roadside vegetation, and brownfields/unmanaged urban greenery. Cultural ES were the most studied, although it is well known that UGS also supply many provisioning and regulating ES. Health (mental and physical) and good social relations were the most investigated wellbeing dimensions, and food security received the least attention. Regarding the methodologies used to investigate the UGS contribution to human wellbeing, surveys, indicators, and surveys combined with statistical methods were the most common. Only a few works focusing on spatial modelling were validated, which is critical to ensure the reliability of the spatial models applied to UGS ES studies. Overall, this work identified the research gaps and future perspectives in ES and wellbeing dimensions provided by UGS, key to improving further research.
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| 7. |
- Aliabad, Fahime Arabi, et al.
(författare)
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Investigating the Ability to Identify New Constructions in Urban Areas Using Images from Unmanned Aerial Vehicles, Google Earth, and Sentinel-2
- 2022
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Ingår i: Remote Sensing. - : MDPI. - 2072-4292. ; 14:13
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Tidskriftsartikel (refereegranskat)abstract
- One of the main problems in developing countries is unplanned urban growth and land use change. Timely identification of new constructions can be a good solution to mitigate some environmental and social problems. This study examined the possibility of identifying new constructions in urban areas using images from unmanned aerial vehicles (UAV), Google Earth and Sentinel-2. The accuracy of the land cover map obtained using these images was investigated using pixel-based processing methods (maximum likelihood, minimum distance, Mahalanobis, spectral angle mapping (SAM)) and object-based methods (Bayes, support vector machine (SVM), K-nearest-neighbor (KNN), decision tree, random forest). The use of DSM to increase the accuracy of classification of UAV images and the use of NDVI to identify vegetation in Sentinel-2 images were also investigated. The object-based KNN method was found to have the greatest accuracy in classifying UAV images (kappa coefficient = 0.93), and the use of DSM increased the classification accuracy by 4%. Evaluations of the accuracy of Google Earth images showed that KNN was also the best method for preparing a land cover map using these images (kappa coefficient = 0.83). The KNN and SVM methods showed the highest accuracy in preparing land cover maps using Sentinel-2 images (kappa coefficient = 0.87 and 0.85, respectively). The accuracy of classification was not increased when using NDVI due to the small percentage of vegetation cover in the study area. On examining the advantages and disadvantages of the different methods, a novel method for identifying new rural constructions was devised. This method uses only one UAV imaging per year to determine the exact position of urban areas with no constructions and then examines spectral changes in related Sentinel-2 pixels that might indicate new constructions in these areas. On-site observations confirmed the accuracy of this method.
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| 8. |
- Aliabad, Fahime Arabi, et al.
(författare)
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Use of Landsat 8 and UAV Images to Assess Changes in Temperature and Evapotranspiration by Economic Trees following Foliar Spraying with Light-Reflecting Compounds
- 2022
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Ingår i: Remote Sensing. - : MDPI AG. - 2072-4292. ; 14:23
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Tidskriftsartikel (refereegranskat)abstract
- Pistachio is an important economic crop in arid and semi-arid regions of Iran. A major problem leading to a reduction in crop quality and reduced marketability is extreme air temperature in summer, which causes sunburn of pistachio leaves and fruit. A solution proposed to deal with the negative effects of high temperatures and increase water consumption efficiency in pistachio orchards is use of light-reflecting compounds. This study investigated the effect of foliar application of gypsum, sulfur, and NAX-95 (calcium-based suspension coating) to trees in a pistachio orchard (150 ha) in central Iran. The effect of these foliar products is assessed at plot scale, using control plots sprayed with calcium sulfate, based on temperature and evapotranspiration changes analyzed through remote sensing. Landsat 8 sensor images and RGB images collected by UAVs (spatial resolution of 30 m and 20 cm, respectively), on the same dates, before and after foliar spray application, were merged using the PCA method and bilinear interpolation re-sampling. Land surface temperature (LST) was then estimated using the split-window algorithm, and daily evapotranspiration using the surface energy balance algorithm for land (SEBAL) algorithm. A land use map was prepared and used to isolate pistachio trees in the field and assess weed cover, whose effect was not accounted. The results showed that temperature remained constant in the control plot between the spraying dates, indicating no environmental changes. In the main plots, gypsum had the greatest effect in reducing the temperature of pistachio trees. The plots with foliar spraying with gypsum displayed a mean tree temperature (47–48 °C) decrease of 3.3 °C in comparison with the control plots (>49 °C), leading to an average decline in evapotranspiration of 0.18 mm/day. NAX-95 and sulfur reduced tree temperature by on average 1.3 °C and 0.6 °C, respectively. Thus, gypsum is the most suitable foliar-spraying compound to lower the temperature of pistachio trees, reduce the water requirement, and increase crop productivity.
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| 9. |
- An, Yiming, et al.
(författare)
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Temporal changes on soil conservation services in large basins across the world
- 2022
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Ingår i: Catena (Cremlingen. Print). - : Elsevier BV. - 0341-8162 .- 1872-6887. ; 209
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Tidskriftsartikel (refereegranskat)abstract
- Soil erosion is one of the main drivers of land degradation across the world, thus soil conservation service has received increasing attention. Limited studies have focused on it, hence this study investigates spatial and temporal patterns on soil conservation service in four large representative basins globally (i.e., Amazon, Mississippi, Yangtze, and Yellow River Basins), between 2001 and 2018. Annual soil conservation service and soil erosion rate are estimated under RUSLE framework, and temporal trends are analyzed using Mann-Kendall test. Additionally, impacts of soil erosion factors on spatial distribution of soil conservation service are assessed through fitting stepwise regressions annually and calculating the factors' contributions. Furthermore, driving factors of temporal changes are identified as climate or land cover dominated, and combined effect of both, according to Z scores from Mann-Kendall test for soil conservation service, R and C factors. Results show the Yangtze River Basin produces the highest average annual erosion rate (mean values of 133.28 Mg ha(-1) yr(-1) in 2001 and 143.21 Mg ha(-1) yr(-1) in 2018) and average soil conservation service (mean values of 2663.57 Mg ha(-1) yr(-1) in 2001 and 3126.43 Mg ha(-1) yr(-1) in 2018). Amazon River Basin yields the lowest average annual soil erosion rate (15.96 Mg ha(-1) yr(-1) in 2001 and 21.30 Mg ha(-1) yr(-1) in 2018), whereas the Mississippi River Basin produces the lowest average soil conservation service (388.48 Mg ha(-1) yr(-1) in 2001 and 730.70 Mg ha(-1) yr(-1) in 2018). Over the study period, soil conservation service shows an increasing trend in the Yangtze and Yellow River Basins, with average changing rates of 27.23 Mg ha(-1) yr(-1) and 16.60 Mg ha(-1) yr(-1), respectively. Increasing soil conservation service is mainly driven by climate change (i.e., rainfall) and the combined effect of climate and land cover changes, but terrain conditions are the main spatial drivers.
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| 10. |
- Bai, Xiaohang, et al.
(författare)
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Precipitation drives the floristic composition and diversity of temperate grasslands in China
- 2021
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Ingår i: Global Ecology and Conservation. - : Elsevier BV. - 2351-9894. ; 32
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Tidskriftsartikel (refereegranskat)abstract
- Effects of environmental factors on plant diversity in temperate grasslands are of interest since experiments have found plant diversity is related to ecosystem function. Although previous studies have focused on the effects of environmental factors on plant diversity, the dominant environmental factors driving diversity differences among plant community types in temperate grasslands at regional scale remains unclear. We established 38 sampling sites (45 m x 45 m) in the main distribution areas of temperate grasslands to analyze the responses of plant community along different environmental gradients and identifies the dominant environmental factors driving the floristic composition and diversity in Inner Mongolia, China. In addition, environmental variables (annual mean temperature, annual precipitation, altitude, disturbance intensity, soil pH, soil density, soil water content, soil organic carbon, soil total nitrogen, soil total phosphorus, soil calcium carbonate), species diversity indices (richness, heterogeneity, evenness), functional diversity indices (abundance, evenness, divergence, dispersion) and plant biomass were analyzed. A total of 179 vascular plant species belonging to 43 families and 113 genera were recorded and classified into six plant community types (Stipa grandis community, Leymus chinensis community, Stipa capillata community, Artemisia frigida community, Cleistogenes squarrosa community, Artemisia halodendron community) based on Ward's agglomerative hierarchical clustering. According to canonical correspondence analysis and Monte Carlo permutation test, mean annual precipitation was the dominant environmental factor driving temperate grasslands, promoting species richness, heterogeneity, evenness, functional divergence and biomass. Soil organic carbon, water content and total nitrogen played positive effects on species diversity, meanwhile, mean annual temperature, altitude, grazing intensity and soil pH inhibited species diversity, functional abundance, dispersion and biomass. Furthermore, the presence of these plant communities dominated by Cleistogenes squarrosa and Artemisia halodendron indicate that grassland degradation is imminent or has already begun. In summary, our results provide evidence on the responses of composition, functional traits and biomass among different plant community types to environmental factors and demonstrate that precipitation is the dominant factors driving the floristic composition and diversity in temperate grasslands.
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