A Blueprint for the Stabilization of Sub-Valent Alkaline Earth Complexes.

The study of sub-valent Group 2 chemistry is a relatively new research field, being established in 2007 with the report of the first Mg(I) dimers. These species are stabilized by the formation of a Mg-Mg covalent bond; however, the extension of this chemistry to heavier alkaline earth (AE) metals has been frustrated by significant synthetic challenges, primarily associated with the instability of heavy AE-AE interactions. Here we present a new blueprint for the stabilization of heavy AE(I) complexes, based upon the reduction of AE(II) precursors with planar coordination geometries. We report the synthesis and structural characterisation of homoleptic trigonal planar AE(II) complexes of the monodentate amides {N(SiMe3 )2 }- and {N(Mes)(SiMe3 )}- . DFT calculations showed that the LUMOs of these complexes all show some d-character for AE = Ca-Ba. DFT analysis of the square planar Sr(II) complex [Sr{N(SiMe3 )2 }(dioxane)2 ]∞ revealed analogous frontier orbital d-character. AE(I) complexes that could be accessed by reduction of these AE(II) precursors were modelled computationally, revealing exergonic formation in all cases. Crucially, NBO calculations show that some d-character is preserved in the SOMO of theoretical AE(I) products upon reduction, showing that d-orbitals could play a crucial role in achieving stable heavy AE(I) complexes.

Ward-level leadership quality and prospective low-back pain of eldercare workers: do resident handlings mediate the association?

OBJECTIVE: We investigated the extent to which ward-level leadership quality was associated with prospective low-back pain among eldercare workers, and how this association was mediated by observed resident handlings. METHODS: 530 Danish eldercare workers, employed in 121 wards, distributed across 20 nursing homes were evaluated. At baseline, leadership quality was measured using the Copenhagen Psychosocial Questionnaire, and resident handlings [handlings per shift, handlings not using assistive devices, handlings done alone, interruptions to handlings, impediments to handlings] were assessed using observations. Frequency and intensity of low-back pain was assessed monthly during the following year. All variables were averaged for each ward. We used ordinary least squares regressions to examine direct effects of leadership on low-back pain and indirect effects through handlings, using PROCESS-macro for SPSS. RESULTS: After adjustments for low-back pain at baseline, type of ward, staff ratio (i.e., number of workers divided by number of residents) and proportion of devices not in place, leadership quality showed no effect on prospective low-back pain frequency (ß = 0.01 [- 0.05:0.07]) and a small beneficial effect on pain intensity (ß = - 0.02 [- 0.04:0.00]). Resident handlings did not mediate the association between leadership quality and frequency or intensity of low-back pain. CONCLUSIONS: Good leadership quality was associated with a small decrease in prospective low-back pain intensity, but resident handlings did not seem to play a mediating role, although better ward-level leadership quality contributed to fewer workplace-observed resident handlings without assistance. Potentially, organizational factors, such as type of ward and staff ratio, may have a greater influence on handlings and low-back pain than leadership quality per se among eldercare workers.

Pain management in eldercare employees - the role of managers in addressing musculoskeletal pain and pain-related sickness absence.

PURPOSE: Managers' knowledge and behaviors in addressing musculoskeletal pain and sickness absence is not well understood. We investigated the association between managers' knowledge and behaviours in relation to employees' pain and their future risk of musculoskeletal pain and associated sickness absence. METHODS: The prospective study included 535 eldercare employees, and 42 managers from 20 nursing homes. Managers' self-reported knowledge and behaviors in relation to employees' pain were grouped using Principal Components Analysis. Eldercare employees reported pain-related sickness absence, and number of days with musculoskeletal pain repeatedly over 1 year. We investigated associations using mixed-effects regression models. RESULTS: We identified four types of managers' knowledge and behaviors: 1) Pain-prevention (actions for prevention of employee pain), 2) Pain-management (actions to assist employees manage pain), 3) Pain-entitlements (communicating entitlements to employees with pain), and 4) Pain-accommodations (ability to facilitate workplace accommodations for employees with pain). The employees of managers with higher scores on knowledge of pain-entitlements reported fewer days of pain-related sickness absence (ß = -0.62; 95%CI [-1.14; -0.10]). The employees of managers with higher scores on pain-management were more likely to report low back pain (ß = 0.57; 95%CI [0.02; 1.11]). We found several key associations between the knowledge and behaviors measures and pain-related sickness absence (interactions). CONCLUSION: Managers' knowledge and behaviors in relation to employees' pain were associated with employees' future musculoskeletal pain and sickness absence. The relationships are complex, suggesting that a multifaceted approach is needed to ensure that managers are adequately informed on how to manage and accommodate employees with musculoskeletal pain to reduce sickness absence.

Associations between perceived quantitative work demands at different organisational levels and pain and sickness absence in eldercare workers: a multi-level longitudinal analysis.

PURPOSE: Eldercare work is characterised by high quantitative work demands and high occurrence of musculoskeletal pain and sickness absence. Our aim was to investigate the association between quantitative demands aggregated at the different organizational levels of eldercare and low back pain (LBP) and sickness absence due to pain among workers. METHODS: This study was conducted in 527 eldercare workers from 105 wards across 20 nursing homes in Denmark. We collected workers' perceived quantitative demands at baseline and workers' LBP and sickness absence repeatedly over the following year. We aggregated worker-level quantitative demands to the ward and nursing home-levels, and used mixed-effects regression models to investigate the associations between quantitative demands at different organizational levels and LBP and sickness absence over 1 year. RESULTS: Across all models, increased quantitative demands (0-100 scale) at the worker-level was associated with an increased likelihood (OR 1.02) and intensity of LBP (ß = 0.01). We did not identify any associations between quantitative demands at the ward-level and either of our outcomes. Across all models, increased quantitative demands at the nursing home-level was associated with increased days with sickness absence due to pain (ß = 0.03 to 0.06). CONCLUSION: In eldercare, workers' perceived quantitative demands are associated with the presence and intensity of LBP. Further, quantitative demands across the overall nursing home-level are associated with sickness absence due to pain among eldercare workers. These results are of relevance to developing organisational interventions targeting quantitative demands to reduce sickness absence in eldercare.

Structural Investigation of Magnesium Complexes Supported by a Thiopyridyl Scorpionate Ligand.

Herein, we report the synthesis of a series of heteroleptic magnesium complexes stabilized with the scorpionate ligand tris(2-pyridylthio)methanide (Tptm). The compounds of the general formula [Mg(Tptm)(X)] (1-X; X = Cl, Br, I) were obtained via protonolysis reaction between the proligand and selected Grignard reagents. Attempts to isolate the potassium derivative K(Tptm) lead to decomposition of Tptm and formation of the alkene (C5H4N-S)2C=C(C5H4N-S)2, and this degradation was also modelled using DFT methods. Compound 1-I was treated with K(CH2Ph), affording the degradation product [Mg(Bptm)2] (2; Bptm = {CH(S-C5NH3)2}-). We analyzed and quantified the steric properties of the Tptm ligand using the structural information of the compounds obtained in this study paired with buried volume calculations, also adding the structural data of HTptm and its CF3-substituted congener (HTptmCF3). These studies highlight the highly flexible nature of this ligand scaffold and its ability to stabilize various coordination motifs and geometries, which is a highly desirable feature in the design of novel organometallic reagents and catalysts.

The utilization of allied and community health services by cancer patients living in regional and remote geographical areas in Australia.

INTRODUCTION: Cancer patients in Australia's Northern Territory (NT) face unique challenges to accessing cancer-related community and allied health services (referred here as 'health services'). This is in part due to the NT's unique geographic, socioeconomic and demographic profile. This paper describes the use of health services by cancer patients in the NT. METHODS: Adult cancer patients attending appointments at a cancer centre in Darwin, NT and who were diagnosed within the past five years were invited to participate in face-to-face interviews about their use of allied and community health services. A descriptive analysis of health services utilization was conducted. RESULTS: Of the 76 participants interviewed, 63% identified as non-Indigenous, 53% female and 45% lived in very remote areas. Mean age at interview was 58.7 years (SD 13.2). Overall, 82% of participants utilized at least one health service since their cancer diagnosis. All Indigenous participants used at least one service, while 28% of non-Indigenous participants did not use any health service. The services most frequently used by participants were community services (42%) and information sources (40%). CONCLUSION: The findings from this study suggest there is variation in the type of community and allied health services used by NT cancer patients across clinical and demographic groups (including Indigenous status). Further qualitative enquiry is needed to better understand this variation, which may reflect differences in service preference, accessibility, health literacy of patients or patient engagement. Such knowledge may inform service delivery improvements to better support cancer patients through their cancer care pathway.

"It started 30 years ago, and it still haunts me": an exploratory investigation of Territorians' gambling behaviours, harm, and help-seeking for gambling issues in an Australian jurisdiction.

BACKGROUND: There is a lack of qualitative gambling research on lived experience, help-seeking, and gamblers and affected others' views on the regulatory environment in the Northern Territory (NT), Australia. This study provides 1) lived experience of individuals who reported experiencing harms from gambling, 2) insights into help-seeking for gambling issues, 3) and people's views on current legislation on gambling in the NT. The results of this study begin to establish an evidence base that could be used to inform targeted interventions for people experiencing harms from gambling in the NT. METHODS: Semi-structured interviews were conducted with a targeted selection of respondents from the 2015 and 2018 NT Gambling Prevalence and Wellbeing Surveys. The sample (n = 27; age 18+ years; Aboriginal (The term of 'Aboriginal' has used been used throughout the manuscript to reflect Aboriginal and Torres Strait Islander, Indigenous, or First Nations people for purposes of brevity. We respect the diversity among these populations.) and Non-Aboriginal) included weekly (online and venue-based electronic gambling machine (EGM)) gamblers, non-regular gamblers, and those negatively affected by others' gambling. A Framework Analysis approach was used for data analysis. Appropriate ethics approval was obtained. RESULTS: Negative impacts and harms from gambling were experienced by both gamblers and non-gamblers. These included monetary losses, relationship conflicts, emotional distress, and decrements to health. A lack of self-realisation of gambling issues and awareness of the available services, shame, and embarrassment, were reported as the main barriers to help-seeking. Where help was sought, it was primarily informal (e.g., family) and was rarely preventive. In many instances, self-help strategies were successful in controlling one's own gambling. Gamblers suggested regulations should set limits on the daily number of hours of playing, the bet size, and reduced access to EGM. The need for strengthening the existing awareness and education interventions was emphasised. CONCLUSIONS: Viewing the findings from a public health lens, targeted approaches based on specific circumstances may have the potential to minimise harms from gambling, but only for those already experiencing harms. The treatment, policy, and regulatory approaches need to be tailored to address the causes and impacts of harms experienced by people.

Cardiorespiratory fitness, occupational aerobic workload and age: workplace measurements among blue-collar workers.

BACKGROUND: The knowledge, from laboratory studies dating back to the 1950s on the importance of the association between cardiorespiratory fitness and aerobic workload for workers health, is fundamental for promoting sustainable healthy employability among ageing blue-collar workers today. However, the association between cardiorespiratory fitness and aerobic workload has not yet been documented during daily work, and we do not know if it applies to the normal work of blue-collar workers in different age groups. We aim to investigate the association between cardiorespiratory fitness and aerobic workload among blue-collar workers using measurements of 24-h heart rate collected over consecutive working days. METHODS: We analyzed baseline cardiorespiratory fitness, assessed using a sub-maximal cycle ergometer test, and 1-4 days of 24-h heart rate measurement from 497 blue-collar workers participating in the DPHACTO study. We investigated the association between cardiorespiratory fitness and aerobic workload defined as the average percentage of heart rate reserve (%HRR), maximum %HRR and the duration time spent at a high HRR (> 30%) during working hours. The association was assessed using multivariate linear regression models adjusted for age, sex, self-rated health, shift-work, prescription medication and occupation, as well as for different age strata. RESULTS: Higher cardiorespiratory fitness was significantly associated with decreased mean %HRR -0.32 [95% CI -0.39 to -0.25], maximum %HRR -0.35 [95% CI -0.45 to -0.25] and time spent at ≥ 30% HRR; -1.8% [95% CI -2.2 to -1.5%]. These associations were evident across age groups, with slightly stronger associations for workers aged 46-51 (total range 18-68). CONCLUSIONS: Higher cardiorespiratory fitness was associated with the decreased aerobic workload during normal work across all age groups and levels of work intensity. Our findings highlight the importance of cardiorespiratory fitness when considering the workload and its relevance in the promotion of healthy sustainable employment.

Global prevalence of gaming disorder: A systematic review and meta-analysis.

BACKGROUND: Gaming disorder was included in the latest revision of the International Classification of Diseases (11th ed.). Worldwide, prevalence estimates of gaming disorder are considerably heterogeneous and often appear to be exceedingly high. However, few studies have examined the methodological, cultural and/or demographic factors that might explain this phenomenon. This review employed meta-analytic techniques to compute the worldwide-pooled prevalence of gaming disorder and evaluate the potential contributing factors for varied prevalence estimates. METHOD: Prevalence estimates were extracted from 53 studies conducted between 2009 and 2019, which included 226,247 participants across 17 different countries. Study findings were meta-analyzed using a random-effects model. Subgroup and moderator analyses examined potential sources of heterogeneity, including assessment tool and cut-off, participant age and gender, sample size and type, study region, and year of data collection. RESULTS: The worldwide prevalence of gaming disorder was 3.05% (confidence interval: [2.38, 3.91]); this figure was adjusted to 1.96% [0.19, 17.12] when considering only studies that met more stringent sampling criteria (e.g. stratified random sampling). However, these estimates were associated with significant variability. The choice of screening tool accounted for 77% of the variance, with the Lemmens Internet gaming disorder-9, Gaming Addiction Identification Test and Problematic Videogame Playing scales associated with the highest estimates. Adolescent samples, lower cut-off scores and smaller sample size were significant predictors of higher prevalence. Gaming disorder rates were approximately 2.5:1 in favor of males compared to females. CONCLUSION: The worldwide prevalence of gaming disorder appears to be comparable to obsessive-compulsive disorder and some substance-related addictions, but lower than compulsive buying and higher than problem gambling. Gaming disorder prevalence rates appear to be inflated by methodological characteristics, particularly measurement and sampling issues.

Aldehyde dehydrogenase 3A1 activation prevents radiation-induced xerostomia by protecting salivary stem cells from toxic aldehydes.

Xerostomia (dry mouth) is the most common side effect of radiation therapy in patients with head and neck cancer and causes difficulty speaking and swallowing. Since aldehyde dehydrogenase 3A1 (ALDH3A1) is highly expressed in mouse salivary stem/progenitor cells (SSPCs), we sought to determine the role of ALDH3A1 in SSPCs using genetic loss-of-function and pharmacologic gain-of-function studies. Using DarkZone dye to measure intracellular aldehydes, we observed higher aldehyde accumulation in irradiated Aldh3a1-/- adult murine salisphere cells and in situ in whole murine embryonic salivary glands enriched in SSPCs compared with wild-type glands. To identify a safe ALDH3A1 activator for potential clinical testing, we screened a traditional Chinese medicine library and isolated d-limonene, commonly used as a food-flavoring agent, as a single constituent activator. ALDH3A1 activation by d-limonene significantly reduced aldehyde accumulation in SSPCs and whole embryonic glands, increased sphere-forming ability, decreased apoptosis, and improved submandibular gland structure and function in vivo after radiation. A phase 0 study in patients with salivary gland tumors showed effective delivery of d-limonene into human salivary glands following daily oral dosing. Given its safety and bioavailability, d-limonene may be a good clinical candidate for mitigating xerostomia in patients with head and neck cancer receiving radiation therapy.

Prevention Strategies to Address Problematic Gaming: An Evaluation of Strategy Support Among Habitual and Problem Gamers.

Psychosocial problems arising from excessive gaming are a public health issue across the developed world. In its most serious form, problematic gaming is recognized as gaming disorder (GD) in the ICD-11. Research has tended to focus on the value of outpatient treatment for GD, but less attention has been paid to broader prevention strategies to address less serious but nevertheless harmful gaming behaviors. Another gap in this literature has been the lack of involvement of the gaming community as stakeholders to identify feasible prevention approaches. This study investigated: (1) regular and problematic gamers' level of support for different prevention strategies within primary, secondary, and tertiary approaches; and, (2) whether self-efficacy is associated with greater support for prevention strategies, as predicted by the Health Belief Model. A total of 992 participants completed an online survey that evaluated support for problem gaming prevention strategies and included measures of self-efficacy, gaming involvement, and GD symptoms, psychological distress, and mental health help-seeking behaviors. Participants reported stronger support for primary prevention strategies, including education, screening, and warning labels, than for other prevention approaches. Overall, 61% of participants expressed support for primary prevention as compared to secondary (39%) and tertiary (36%) approaches. There was stronger support for outpatient care (48%) than inpatient services (25%). In-game shutdown features received the lowest support (65% disapproval). Contrary to the Health Belief Model, self-efficacy was not associated with prevention support. Younger, female, and less frequent gamers were more likely to support primary and secondary prevention strategies. These findings suggest that gamers may be more favorable toward prevention measures aligned with informed decision-making, autonomy, and self-directed actions. Gamers may be strongly opposed to modifications to the structure of gaming activities (e.g., shutdown features). Future research should evaluate the efficacy and cost-effectiveness of problem gaming prevention measures in different populations and regions.

Insights into the Composition and Structural Chemistry of Gallium(I) Triflate.

"GaOTf" is a simple, convenient source of low-valent gallium for synthetic chemistry and catalysis. However, little is currently known about its composition or reactivity. In this work, 71 Ga NMR spectroscopy shows the presence of [Ga(arene)n ]+ salts on oxidation of Ga metal with AgOTf in arene solvents. However, a more complex picture of speciation is uncovered by X-ray diffraction studies. In all cases, mixed-valence compounds containing Ga-arene and Ga-OTf coordination motifs, in addition to an unusual "naked" [Ga]+ ion, are found. Addition of 18-crown-6 allows for the isolation of a discrete GaI crown complex. Evidence of a potential intermediate in the formation of "GaOTf" has been isolated in the form of the bimetallic silver(I)/gallium(I) cluster anion [Ag4 {Ga(OTf)3 }4 (µ-Ga)6 (OTf)4 ]2- .

Zero problems with compositional data of physical behaviors: a comparison of three zero replacement methods.

BACKGROUND: Researchers applying compositional data analysis to time-use data (e.g., time spent in physical behaviors) often face the problem of zeros, that is, recordings of zero time spent in any of the studied behaviors. Zeros hinder the application of compositional data analysis because the analysis is based on log-ratios. One way to overcome this challenge is to replace the zeros with sensible small values. The aim of this study was to compare the performance of three existing replacement methods used within physical behavior time-use epidemiology: simple replacement, multiplicative replacement, and log-ratio expectation-maximization (lrEM) algorithm. Moreover, we assessed the consequence of choosing replacement values higher than the lowest observed value for a given behavior. METHOD: Using a complete dataset based on accelerometer data from 1310 Danish adults as reference, multiple datasets were simulated across six scenarios of zeros (5-30% zeros in 5% increments). Moreover, four examples were produced based on real data, in which, 10 and 20% zeros were imposed and replaced using a replacement value of 0.5 min, 65% of the observation threshold, or an estimated value below the observation threshold. For the simulation study and the examples, the zeros were replaced using the three replacement methods and the degree of distortion introduced was assessed by comparison with the complete dataset. RESULTS: The lrEM method outperformed the other replacement methods as it had the smallest influence on the structure of relative variation of the datasets. Both the simple and multiplicative replacements introduced higher distortion, particularly in scenarios with more than 10% zeros; although the latter, like the lrEM, does preserve the ratios between behaviors with no zeros. The examples revealed that replacing zeros with a value higher than the observation threshold severely affected the structure of relative variation. CONCLUSIONS: Given our findings, we encourage the use of replacement methods that preserve the relative structure of physical behavior data, as achieved by the multiplicative and lrEM replacements, and to avoid simple replacement. Moreover, we do not recommend replacing zeros with values higher than the lowest observed value for a behavior.

Do organisational and ward-level factors explain the variance in multi-site musculoskeletal pain in eldercare workers? A multi-level cross-sectional study.

PURPOSE: Multi-site musculoskeletal pain (MSP) is highly prevalent among eldercare workers, leading to increased incidence of sickness absence and early retirement. Most research on MSP in eldercare workers has focused on individual-level factors reported by the employees, with limited focus at the organisation and ward level. To address this gap, the aim of this study was to investigate whether organisation and ward-level factors explain the variance in MSP among Danish eldercare workers. METHODS: A multi-level cross-sectional study was conducted among 20 Danish nursing homes, containing 126 wards, and 418 workers who participated in measurements of organisational factors, working environment factors, and MSP (classified as reporting pain in 2 or more body regions). Data were collected at the level of the organisation, ward, and individual. The proportion of variance in MSP explained by each level was estimated using variance components analysis. The association between factors at each level of the organisation and MSP was investigated using generalised linear mixed-effects regression. RESULTS: Sixty seven percent of participants reported having MSP. The organisational and ward-level factors explained 0% of the variance in MSP, while the individual-level factors explained 100% of the variance in MSP. Moreover, no factors at the organisational and ward levels showed statistically significant associations with MSP. Individual-level perceived physical exertion and quantitative demands had a statistically significant association with a higher prevalence of MSP. CONCLUSIONS: The organisation and ward levels did not contribute to explaining any of the variance in MSP. All variance in MSP was explained at the individual level.

Innovative cooling strategies: Dairy cow responses and water and energy use.

Producers in the western United States commonly use spray water at the feed bunk and fans in the lying area to mitigate heat stress in dairy cows. Often, spray water cycles on and off with fans turning on when a preset air temperature is reached. Although this method can be effective, innovative strategies are needed to reduce water and energy use. We evaluated the effectiveness and resource efficiency of 4 cooling treatments on behavioral and physiological responses in dairy cows housed in a freestall barn: (1) conductive cooling in which mats with recirculating evaporatively cooled water were buried under sand bedding (Mat; activated at 18.9°C); (2) targeted convective cooling in which evaporatively cooled air was directed toward the cows through fabric ducts with nozzles at both the feed bunk and lying areas (Targeted Air; activated at 22°C); (3) evaporative cooling, with spray water in the feed area and fan over the freestalls (Baseline; activated at 22°C); and (4) evaporative cooling with half the amount of spray water used in the Baseline and the fan moved to the feed bunk (Optimized Baseline; activated at 22°C). In a crossover design, 8 groups of cows (4/group) producing an average (± standard deviation) of 37.5 ± 4.5 kg/d of milk were tested for 3 d per treatment. For ethical reasons, beginning at 30°C, the Mat treatment was supplemented with Baseline cooling and the Targeted Air treatment had spray water at the Optimized Baseline rate. We recorded body temperature, posture, and location within the pen every 3 min for 24 h/d, and respiration rates every 30 min daily from 1000 to 1900 h. Daily air temperature averaged (±SD) 26.3 ± 7.1°C during 24 h and 33.3 ± 4°C from 1000 to 1900 h. We used pairwise comparisons of each treatment to Baseline to evaluate response variables. Milk production did not differ across treatments, nor did time spent lying (51 ± 2%/d on average). Respiration rates did not differ across treatments overall (61 ± 3 breaths/min), but on an hourly basis, cows in the Mat treatment had a significantly higher rate than those in Baseline, at h 10 and 11 (70 vs. 58-59 breaths/min). Body temperature averaged 38.7 ± 0.05°C across treatments and was 0.2 to 0.3°C higher in the Mat treatment than in Baseline at h 10, 11, 20, 21, and 22. These results collectively indicate that the Mat treatment did not effectively reduce indicators of heat load compared with Baseline. In contrast, Targeted Air and Optimized Baseline were both effective but differed in aspects of efficiency. Targeted Air used the least amount of water but the most energy of all options tested. In conclusion, more efficient heat abatement options were identified, particularly an Optimized Baseline strategy, which cut water use in half, required the same amount of energy as the Baseline, and maintained similar physiological and behavioral responses in cows.

Comparison of physical behavior estimates from three different thigh-worn accelerometers brands: a proof-of-concept for the Prospective Physical Activity, Sitting, and Sleep consortium (ProPASS).

BACKGROUND: Pooling data from thigh-worn accelerometers across multiple studies has great potential to advance evidence on the health benefits of physical activity. This requires harmonization of information on body postures, physical activity types, volumes and time patterns across different brands of devices. The aim of this study is to compare the physical behavior estimates provided by three different brands of thigh-worn accelerometers. METHODS: Twenty participants volunteered for a 7-day free-living measurement. Three accelerometers - ActiGraph GT3X+, Axivity AX3 and ActivPAL Micro4 - were randomly placed in a vertical line on the midsection of the right thigh. Raw data from each accelerometer was processed and classified into 8 physical activities and postures using the Acti4 software. Absolute differences between estimates and the respective coefficient of variation (CV) were calculated. RESULTS: We observed very minor differences between physical behavior estimates from three different accelerometer brands. When averaged over 24 h (1,440 min), the absolute difference (CV) between accelerometers were: 1.2 mins (0.001) for lying/sitting, 3.4 mins (0.02) for standing, 3.5 mins (0.06) for moving, 1.9 mins (0.03) for walking, 0.1 mins (0.19) for running, 1.2 mins (0.19) for stair climbing, 1.9 mins (0.07) for cycling. Moreover, there was an average absolute difference of 282 steps (0.03) per 24 h. CONCLUSIONS: Physical behaviors were classified with negligible difference between the accelerometer brands. These results support harmonization of data from different thigh-worn accelerometers across multiple cohorts when analyzed in an identical manner.

Correction to: Evaluating changes in electronic gambling machine policy on user losses in an Australian jurisdiction.

It was highlighted that in the original article [1] Fig. 3 and Fig. 4 legends were incorrect. This Correction article shows Fig. 3 and Fig. 4 with their correct legend.

Evaluating changes in electronic gambling machine policy on user losses in an Australian jurisdiction.

BACKGROUND: Electronic gambling machines (EGMs) are in casinos and community venues (hotels and clubs) in all jurisdictions in Australia, except Western Australia (only in casino). EGMs have a range of features that can affect how people gamble, which can influence losses incurred by users. The Northern Territory Government recently changed two EGM policies - the introduction of note acceptors on EGMs in community venues, and an increase in the cap from 10 to 20 EGMs in hotels and 45 to 55 in clubs. This study evaluates two changes in EGM policy on user losses in community venues, and tracks changes in user losses per adult, EGM gambler, and EGM problem/moderate risk gambler between 2005 and 2015. METHODS: Trends in venue numbers, EGM numbers, user losses and user losses per EGM by venue type and size are presented to determine if EGM policy changes affected user losses. Data from the 2005 and 2015 NT gambling surveys are used to determine EGM user losses per adult, per EGM gambler, and per EGM problem and/or moderate risk gambler, with several assumptions applied. RESULTS: From 2010 (post smoking ban) to 2013 real user losses were stagnant, but from 2013 to 2017, real user losses in community venues increased 19, 9, 8 and 5% per annum, with increases higher in clubs and hotels with the maximum allowable number of EGMs. Over the same period user losses in the two casinos declined by 13%. Between 2005 and 2015, estimated user losses per EGM problem/moderate risk and problem gambler increased by 5 and 34% respectively. CONCLUSIONS: The analysis demonstrates that reductions in how much money gamblers can insert into an EGM (load-up limit), and/or the abolition of note acceptors, and reductions in the number of EGMs in venues is likely to reduce harm from EGM use. Given the demonstrated inability for Australian jurisdictions to identify and implement effective harm prevention and minimisation interventions, a national approach to gambling regulation in Australia may be desirable. Similarly, national co-ordination of research, particularly on EGMs and online betting is required to better understand changes in gambling policy on related harms.

Mechanisms for reducing low back pain: a mediation analysis of a multifaceted intervention in workers in elderly care.

PURPOSE: A multifaceted workplace intervention consisting of participatory ergonomics, physical training, and cognitive-behavioural training (CBT) has shown effectiveness for reducing low back pain (LBP). However, the mechanisms of action underlying these intervention components are not well understood. METHODS: This was a mediation analysis of a cluster-randomised controlled trial of a multifaceted intervention in 420 workers in elderly care. Mediation analysis was carried out via structural equation modelling. Potential mediators investigated were: fear-avoidance beliefs, perceived muscle strength, use of assistive devices at work and perceived physical exertion at work. LBP outcomes assessed were: days with LBP, LBP intensity and days with bothersome LBP. RESULTS: There were no significant indirect effects of the intervention on LBP outcomes. There were significant effects of the intervention on both fear-avoidance measures [ß = - 0.63, 95% CI (1.23, 0.03); ß = - 1.03, 95% CI (- 1.70, - 0.34)] and the use of assistive devices [ß = - 0.55, 95% CI (- 1.04, - 0.05)], but not on perceived muscle strength [ß = - 0.18, 95% CI (- 0.50, 0.13)] or physical exertion [ß = - 0.05, 95% CI (- 0.40, 0.31)]. The only potential mediator with a significant effect on LBP outcomes was physical exertion, which had a significant effect on LBP intensity [ß = 0.14, 95% CI (0.04, 0.23)]. CONCLUSIONS: A multifaceted intervention consisting of participatory ergonomics, physical training, and CBT was able to decrease fear-avoidance beliefs and increase use of assistive devices in the workplace. However, these changes did not explain the effect of any of the intervention components on days with LBP, LBP intensity and days with bothersome LBP.

Cognitive-behavioral therapy for Internet gaming disorder: A systematic review and meta-analysis.

OBJECTIVE: Although there is sufficient research and clinical evidence to support the inclusion of gaming disorder in the latest revision of the International Classification of Diseases, relatively little is known about the effectiveness of first-line psychological treatment for gaming disorder or internet gaming disorder (IGD) as it is listed in the Diagnostic and Statistical Manual. This systematic review employed meta-analytic techniques to determine the effectiveness of cognitive-behavioural therapy (CBT) for IGD on four key outcomes: IGD symptoms, anxiety, depression, and time spent gaming. METHOD: A database search identified 12 independent CBT studies. Effect size estimates (Hedges' g) with associated confidence intervals, prediction intervals, and p values for each pre-post treatment outcome, were calculated. Study reporting quality was evaluated in accordance with the Consolidated Standards of Reporting Trials guidelines. Subgroup and moderator analyses were undertaken to investigate potential sources of heterogeneity. RESULTS: CBT demonstrated high efficacy in reducing IGD symptoms (g = 0.92; [0.50, 1.34]) and depression (g = 0.80, [0.21, 1.38]), and showed moderate efficacy in reducing anxiety (g = 0.55, [0.17, 0.93]) at post-test. There was insufficient power to determine whether CBT was capable of reducing time spent gaming. Treatment gains at follow-up were nonsignificant across the four treatment outcomes. CONCLUSIONS: The pooled findings suggest that CBT for IGD is an effective short-term intervention for reducing IGD and depressive symptoms. However, the effectiveness of CBT for reducing actual time spent gaming was unclear. Given the limitations of this evidence base, there is a need for more rigorous studies to determine the potential long-term benefits of CBT for IGD. PUBLIC HEALTH SIGNIFICANCE STATEMENT: Given the rise in treatment demand for internet gaming disorder (IGD) and problematic gaming, it is necessary to determine which treatments are most effective for whom and under which conditions. This review shows that cognitive-behavioural therapy for IGD, which is often considered the first-line therapy, can improve IGD symptoms and comorbid depression. However, treatment gains tend to be short-term and their effect in reducing time spent gaming is unclear. Programs that target problematic gaming may be improved by additional support beyond the standard program of therapy sessions. More funding and resources are needed to support the development of a more rigorous evidence base on IGD and its treatment.