Running-related demands and vigor in long-distance runners: The moderating role of resources and recovery.

Long-distance running is a demanding sport and runners use a variety of coping strategies to deal with these demands. In this study, we investigated running-related demands, resources, and recovery and, as an indicator of well-being, vigor. Specifically, following the Demand-Induced Strain Compensation Recovery Model, we tested to what degree the relation between running-related demands and vigor was moderated by two coping strategies available in running: running-related resources (e.g., training control, running mate/coach support) and running-related recovery (i.e., detachment from running). Demands, resources, recovery, and vigor were all surveyed across three separate dimensions (i.e., physical, cognitive, emotional) in a cross-sectional sample of 623 recreational long-distance runners. Hierarchical regression analyses were used to determine to what degree the demands-vigor relation was moderated by resources and recovery. Evidence for moderations was found for the cognitive and emotional dimensions of vigor, revealing four significant moderating effects of resources or recovery on the demands-vigor relation. Three of these effects involved emotional resources or recovery. Contrary to expectations, results also showed that in two cases higher recovery was associated with lower vigor, rather than higher, when runners experienced high demands. In all, we found modest support for the role of resources and recovery in altering the nature of the demands-vigor relation in recreational long-distance runners. This study highlights the importance of the emotional dimension of demands, resources, and recovery, as those facets were most important in predicting vigor in runners. Practical implications are addressed with regard to emotional resources and recovery for long-distance runners

Association between personal protective equipment and SARS-CoV-2 infection risk in emergency department healthcare workers

Background and importance Healthcare personnel working in the emergency department (ED) is at risk of acquiring severe acute respiratory syndrome coronavirus-2 (SARS-Cov-2). So far, it is unknown if the reported variety in infection rates among healthcare personnel is related to the use of personal protective equipment (PPE) or other factors. Objective The aim of this study was to investigate the association between PPE use and SARS-CoV-2 infections among ED personnel in the Netherlands. Design, setting and participants A nationwide survey, consisting of 42 questions about PPE-usage, ED layout - and workflow and SARS-CoV-2 infection rates of permanent ED staff, was sent to members of the Dutch Society of Emergency Physicians. Members were asked to fill out one survey on behalf of the ED of their hospital. The association between PPE use and the infection rate was investigated using univariable and multivariable regression analyses, adjusting for potential confounders. Outcome measures Primary outcome was the incidence of confirmed SARS-CoV-2 infections among permanent ED staff between 1 March and 15 May 2020. Results Surveys were sent to 64 EDs of which 45 responded (70.3%). In total, 164 ED staff workers [5.1 (3.2-7.0)%] tested positive for COVID-19 during the study period compared to 0.087% of the general population. There was significant clustering of infected ED staff in some hospitals (range: 0-23 infection). In 13 hospitals, an FFP2 (filtering facepiece particles >94% aerosol filtration) mask or equivalent and eye protection was worn for all contacts with patients with suspected or confirmed SARS-CoV-2 during the whole study period. The unadjusted staff infection rate was higher in these hospitals [7.3 (3.4-11.1) vs. 4.0 (1.9-6.1)%, absolute difference + 3.3%]. Hospital staff testing policy was identified as a potential confounder of the relation between PPE use and confirmed SARS-CoV-2 infections (collinearity statistic 0.95). After adjusting for hospital testing policy, type of PPE was not associated with incidence of COVID 19 infections among ED staff (P = 0.40). Conclusion In this cross-sectional study, the use of high-level PPE (FFP2 or equivalent and eye protection) by ED personnel during all contacts with patients with suspected or confirmed SARS-CoV-2 does not seem to be associated with a lower infection rate of ED staff compared to lower level PPE use. Attention should be paid to ED layout and social distancing to prevent cross-contamination of ED personnel

An applied methodology for stakeholder identification in transdisciplinary research

In this paper we present a novel methodology for identifying stakeholders for the purpose of engaging with them in transdisciplinary, sustainability research projects. In transdisciplinary research, it is important to identify a range of stakeholders prior to the problem-focussed stages of research. Early engagement with diverse stakeholders creates space for them to influence the research process, including problem definition, from the start. However, current stakeholder analysis approaches ignore this initial identification process, or position it within the subsequent content-focussed stages of research. Our methodology was designed as part of a research project into a range of soil threats in seventeen case study locations throughout Europe. Our methodology was designed to be systematic across all sites. It is based on a snowball sampling approach that can be implemented by researchers with no prior experience of stakeholder research, and without requiring significant financial or time resources. It therefore fosters transdisciplinarity by empowering physical scientists to identify stakeholders and understand their roles. We describe the design process and outcomes, and consider their applicability to other research projects. Our methodology therefore consists of a two-phase process of design and implementation of an identification questionnaire. By explicitly including a design phase into the process, it is possible to tailor our methodology to other research projects

Endoscopic mucosal resection (EMR) versus endoscopic submucosal dissection (ESD) for resection of large distal non-pedunculated colorectal adenomas (MATILDA-trial): Rationale and design of a multicenter randomized clinical trial

Background: Endoscopic mucosal resection (EMR) is currently the most used technique for resection of large distal colorectal polyps. However, in large lesions EMR can often only be performed in a piecemeal fashion resulting in relatively low radical (R0)-resection rates and high recurrence rates. Endoscopic submucosal dissection (ESD) is a newer procedure that is more difficult resulting in a longer procedural time, but is promising due to the high en-bloc resection rates and the very low recurrence rates. We aim to evaluate the (cost-)effectiveness of ESD against EMR on both short (i.e. 6 months) and long-term (i.e. 36 months). We hypothesize that in the short-run ESD is more time consuming resulting in higher healthcare costs, but is (cost-) effective on the long-term due to lower patients burden, a higher number of R0-resections and lower recurrence rates with less need for repeated procedures. Methods: This is a multicenter randomized clinical trial in patients with a non-pedunculated polyp larger than 20 mm in the rectum, sigmoid, or descending colon suspected to be an adenoma by means of endoscopic assessment. Primary endpoint is recurrence rate at follow-up colonoscopy at 6 months. Secondary endpoints are R0-resection rate, perceived burden and quality of life, healthcare resources utilization and costs, surgical referral rate, complication rate and recurrence rate at 36 months. Quality-adjusted-life-year (QALY) will be estimated taking an area under the curve approach and using EQ-5D-indexes. Healthcare costs will be calculated by multiplying used healthcare services with unit prices. The cost-effectiveness of ESD against EMR will be expressed as incremental cost-effectiveness ratios (ICER) showing additional costs per recurrence free patient and as ICER showing additional costs per QALY. Discussion: If this trial confirms ESD to be favorable on the long-term, the burden of extra colonoscopies and repeated procedures can be prevented for future patients. Trial registration:NCT02657044(Clinicaltrials.gov), registered January 8, 2016

Influence of filter age on Fe, Mn and NH4+ removal in dual media rapid sand filters used for drinking water production

Rapid sand filtration is a common method for removal of iron (Fe), manganese (Mn) and ammonium (NH4+) from anoxic groundwaters used for drinking water production. In this study, we combine geochemical and microbiological data to assess how filter age influences Fe, Mn and NH4+ removal in dual media filters, consisting of anthracite overlying quartz sand, that have been in operation for between ∼2 months and ∼11 years. We show that the depth where dissolved Fe and Mn removal occurs is reflected in the filter medium coatings, with ferrihydrite forming in the anthracite in the top of the filters ( 1 m). Removal of NH4+ occurs through nitrification in both the anthracite and sand and is the key driver of oxygen loss. Removal of Fe is independent of filter age and is always efficient (> 97% removal). In contrast, for Mn, the removal efficiency varies with filter age, ranging from 9 to 28% at ∼2–3 months after filter replacement to 100% after 8 months. After 11 years, removal reduces to 60–80%. The lack of Mn removal in the youngest filters (at 2–3 months) is likely the result of a relatively low abundance of mineral coatings that adsorb Mn2+ and provide surfaces for the establishment of a microbial community. 16S rRNA gene amplicon sequencing shows that Gallionella, which are known Fe2+ oxidizers, are present after 2 months, yet Fe2+ removal is mostly chemical. Efficient NH4+ removal (> 90%) establishes within 3 months of operation but leakage occurs upon high NH4+loading (> 160 µM). Two-step nitrification by Nitrosomonas and Candidatus Nitrotoga is likely the most important NH4+ removal mechanism in younger filters during ripening (2 months), after which complete ammonia oxidation by Nitrospira and canonical two-step nitrification occur simultaneously in older filters. Our results highlight the strong effect of filter age on especially Mn2+but also NH4+ removal. We show that ageing of filter medium leads to the development of thick coatings, which we hypothesize leads to preferential flow, and breakthrough of Mn2+. Use of age-specific flow rates may increase the contact time with the filter medium in older filters and improve Mn2+ and NH4+ removal

Recovery of dialysis patients with COVID-19 : health outcomes 3 months after diagnosis in ERACODA

Background. Coronavirus disease 2019 (COVID-19)-related short-term mortality is high in dialysis patients, but longer-term outcomes are largely unknown. We therefore assessed patient recovery in a large cohort of dialysis patients 3 months after their COVID-19 diagnosis. Methods. We analyzed data on dialysis patients diagnosed with COVID-19 from 1 February 2020 to 31 March 2021 from the European Renal Association COVID-19 Database (ERACODA). The outcomes studied were patient survival, residence and functional and mental health status (estimated by their treating physician) 3 months after COVID-19 diagnosis. Complete follow-up data were available for 854 surviving patients. Patient characteristics associated with recovery were analyzed using logistic regression. Results. In 2449 hemodialysis patients (mean ± SD age 67.5 ± 14.4 years, 62% male), survival probabilities at 3 months after COVID-19 diagnosis were 90% for nonhospitalized patients (n = 1087), 73% for patients admitted to the hospital but not to an intensive care unit (ICU) (n = 1165) and 40% for those admitted to an ICU (n = 197). Patient survival hardly decreased between 28 days and 3 months after COVID-19 diagnosis. At 3 months, 87% functioned at their pre-existent functional and 94% at their pre-existent mental level. Only few of the surviving patients were still admitted to the hospital (0.8-6.3%) or a nursing home (∼5%). A higher age and frailty score at presentation and ICU admission were associated with worse functional outcome. Conclusions. Mortality between 28 days and 3 months after COVID-19 diagnosis was low and the majority of patients who survived COVID-19 recovered to their pre-existent functional and mental health level at 3 months after diagnosis

Compensation for displacement caused by dam building : representation, recognition, and outcomes in Thailand

Compensation of people affected by dam building can be unfair, leading to protests and delays. Several international guidelines exist for compensation procedures that aim at equitable and reasonable compensation. Different criteria and procedures have been proposed for valuation of lost assets and income. We investigated five dam-building projects in Thailand, and evaluated the compensation process and outcomes with a conceptual framework focused on recognition of values, representation of affected people, actual compensation and acceptance of the project and compensation by the affected people. We studied the representation and recognition of languages of valuation in the compensation negotiation processes, and outcomes of the compensation in terms of cash-for-land payments and acceptance of the projects by the affected people. We propose and applied a ‘Comparative Index’ to compare paid cash compensations in the five projects with average family income in the respective regions. The results show deficient representation, insufficient attention to multiple languages of valuation, low compensations for lost land and trees and low degrees of acceptance by the affected people

Institutionalizing participation in water resource development : Bottom-up and top-down practices in Southern Thailand

Substantive stakeholder engagement is increasingly recognized as essential for effective water resource development. Infrastructure development projects and strategies are however typically designed by engineers first before initiating discussions about impacts with stakeholders. In altering this sequence, designing meaningful participatory planning processes needs careful attention. This requires an innovative approach taking into account the institutional and discursive structure of the negotiation arena. This study uses eight features of participation and related micro-politics questions to scrutinize the design process of two water resource development projects in Thailand. The research shows that in one case some of the affected stakeholders were excluded, and in the other case, a lack of trust made one village obstruct the design process from the start. In both cases, the capacity to facilitate the negotiation about alternative designs and compensation was deficient. It is concluded that participation should be institutionalized and facilitated in a way that fosters accountable representation by all stakeholders, builds trust, and recognizes stakeholder interests and knowledge. The approach taken helps to understand the outcomes of the planning process and is useful to design planning processes that foster the accountable representation of all stakeholders and the recognition of their interests and knowledge.</p

Linking psychological risk profiles to running-related injuries and chronic fatigue in long-distance runners: A latent profile analysis

Introduction Consistently predicting adverse outcomes of long-distance running, such as running-related injuries (RRIs) and chronic fatigue, has proven to be a complicated matter. However, research suggests that a stronger focus on psychological factors of runners might provide further insights. Consequently, in this study, we explored the interplay between self-regulatory coping strategies and motivational aspects. Using a person-centered approach, we investigated whether latent psychological profiles of runners were associated with RRIs and chronic fatigue. Methods Questionnaire data were gathered from Dutch recreational long-distance runners (N = 425) using a cross-sectional design. We determined whether specific psychological combinations (i.e., latent profiles) based on coping strategies (i.e., running-related resources and recovery) and motivational aspects (i.e., harmonious and obsessive passion) could be distinguished using latent profile analysis (LPA). The resulting profiles were tested for their associations with RRIs and chronic fatigue. Results LPA revealed three different psychological risk profiles, termed the ‘low-risk’, ‘medium-risk’, and ‘high-risk’ profile. The low-risk profile showed low scores on obsessive passion and high scores on all recovery dimensions, whereas the high-risk profile resembled the opposite pattern. Furthermore, the low-risk profile showed significantly fewer RRIs and lower chronic fatigue scores than the high-risk profile. Discussion The results reveal that (1) patterns of passion and coping strategies interact in defining different profiles and (2) that such profiles are indeed linked to RRIs and chronic fatigue. Utilizing profiles might enable targeted intervention and more effective preventative measures by pinpointing at-risk runners. Specific combinations of psychological aspects, as reflected by our profiles, thus appear a worthwhile direction to consider in understanding RRIs and chronic fatigue in long-distance running