Experiences of peer navigators implementing a bilingual multilevel intervention to address sexually transmitted infection and HIV disparities and social determinants of health.

INTRODUCTION: Sexually transmitted infections (STIs) and human immunodeficiency virus (HIV) disproportionately affect young gay, bisexual and other men who have sex with men (GBMSM) and transgender women of colour. We explored the experiences of community-based peer navigators ('Community Navigators') who participated in Impact Triad, a bilingual multilevel intervention developed by our community-based participatory research partnership to reduce STIs and HIV and address social determinants of health (e.g., employment, education, social support and discrimination) among young GBMSM and transgender women of colour. METHODS: Individual in-depth interviews were conducted with 15 Community Navigators who participated in Impact Triad. Themes were identified through constant comparison. RESULTS: Community Navigators' mean age was 31.4 years. Seven were self-identified as African American/Black, 5 as Latine, 2 as multiracial/multiethnic, 1 as Asian American, 10 as cisgender men, 4 as transgender women and 1 as gender nonbinary. Thirteen themes emerged in three domains: (1) key aspects of the Community Navigator role (e.g., desire to serve as a community resource, the importance of being part of the communities in which one was working, the value of having an official role, being connected to other Community Navigators to problem-solving and sustaining intervention aspects long-term); (2) experiences implementing Impact Triad (e.g., engaging community members, meeting prioritized needs, building trust, using social media, increasing awareness and knowledge and challenges related to COVID-19) and (3) lessons learned for future interventions (e.g., facilitating access to broader resources, building additional skills and increasing interactions among Community Navigators). CONCLUSION: Interviews identified important learnings about serving as Community Navigators and implementing Impact Triad that can guide future efforts to address STI/HIV disparities and social determinants of health through community-based peer navigation. PATIENT OR PUBLIC CONTRIBUTION: Throughout this intervention trial, our partnership worked collaboratively with a study-specific community advisory board (CAB) comprised primarily of young GBMSM and transgender women of colour. Members of this CAB participated in all aspects of the trial including trial design, intervention development, recruitment and retention strategies, data collection and analysis, interpretation of findings and dissemination.

Visual Communication and Creative Processes Within the Primary Care Consultation.

Discussion of the value of image, metaphor and creative principles to good consulting skill and patient education within the Primary Care setting is important in enhancing improved patient-physician interactions. A broad-based view of the techniques used in undergraduate and postgraduate teaching within Medical Education in the UK and US are canvassed to establish the best practices and efficacy of using drawings and images as communication tools between physicians and patients. A descriptive analysis of the author's use of image and metaphor is analysed to assess how such convey medical information and help in the improvement of consultation and patient understanding.

Effect of Mouthwashes for COVID-19 Prevention on Surface Changes of Resin Composites.

OBJECTIVE: The aim of this research was to investigate the effect of various mouthwashes for COVID-19 prevention on surface hardness, roughness, and colour changes of bulk-fill and conventional resin composites and determine the pH and titratable acidity of mouthwashes. METHODS: Four hundred eighty specimens were fabricated in cylindrical moulds (10 mm in diameter and 2 mm in thickness). Before immersion, baseline data of surface hardness, roughness, and colour values were recorded. Each product of specimens (Filtek Z350XT, Premise, Filtek One Bulk Fill Restorative, SonicFil 2) were divided into 4 groups for 0.2% povidone iodine, 1% hydrogen peroxide, 0.12% chlorhexidine, and deionised water (serving as a control). The specimens were immersed in mouthwashes for 1 minute and then stored in artificial saliva until 24 hours. This process was repeated for 14 days. After immersion, surface hardness, roughness, and colour values of specimens were measured at 7 and 14 days. The data were statistically analysed by 2-way repeated analysis of variance, Tukey honestly significant difference, and t test (P < .05). RESULTS: After immersion, all mouthwashes caused significantly lower surface hardness and greater roughness and colour values (P < .05) on all resin composites tested. CONCLUSIONS: Mouthwashes had an effect on all resin composites evaluated leading to a significant decreased surface hardness and an increased roughness and colour values (P < .05).

Colour Preference and Healing in Digital Roaming Landscape: A Case Study of Mental Subhealth Populations.

From the perspective of emotional preference, studies have been conducted about landscape healing for subhealth people in the National High-Tech Zone (the study area). Combined with a preliminary practice investigation, Unity 2019 was used to make a digital roaming landscape, and 91 subjects with a history of mental subhealth diseases were randomly invited to participate in the immersive experimentation of the Human-Machine Environment Synchronisation (ErgoLAB) platform. After the experiment, the subjects were invited to fill in a Likert scale as the control group. The interest preference, emotion fluctuation, and healing effect of landscape colour were verified. The results show that: (1) The variation trend of interest reflected the concentration of interest in landscape, and the order of degree of interest, ranging from high to low, went Green > Yellow > Blue > Red > Orange > Purple > Cyan. (2) The subjects' interest in landscape colour was correlated with the arousal of positive emotions. The correlation between interest in landscape colour and positive emotions, from high to low, went Blue > Green > Yellow, while the correlation between red, cyan, orange, and purple was not significant. (3) The mean skin conductance (SC) fluctuation variance of subjects was 5.594%, which confirmed that the healing effect of digital roaming landscape scenes was significant under the state of low arousal. According to the Likert scale data, subjects' scores of the healing effect of landscapes, from high to low, went as follows: Green > Yellow > Red > Blue > Cyan > Orange > Purple. The results provide a new method for demonstrating the logical relationship between the digital landscape interest experience-emotional awakening-healing effect and providing a theoretical method and construction scheme for landscape colour configuration in the implementation of landscape healing projects.

COVID-19 Skin Manifestations in Skin of Colour.

Coronavirus disease (COVID-19) skin manifestations have been increasingly reported in medical literature. Recent discussions have identified a lack of images of skin of color (SOC) patients with COVID-19 related skin findings despite people with skin of color being disproportionately affected with the disease. There have been calls to prioritize the identification of COVID-19 skin manifestations in patients with SOC and disseminate these findings. The objective of this article is to review the existing literature on COVID-19 skin manifestations and, where possible, discuss how they may present differently in patients with SOC. Further research is needed to allow primary care physicians and dermatologists to be aware of and easily identify patients with cutaneous findings that may be secondary to COVID-19. Patients presenting with idiopathic dermatologic manifestations should be considered for COVID-19 testing and follow public health guidelines for self-isolation.

Current perspectives on dental adhesion: (2) Concepts for operatively managing carious lesions extending into dentine using bioactive and adhesive direct restorative materials.

This article reviews the current concepts for operatively managing carious lesions extending into dentine with minimal removal of tooth structure and restoring with dentine adhesives and direct composite resin. It looks sequentially at the operative steps involved including remineralisation with bioactive cements, bonding to caries-affected dentine including smear-layer modification using HOCl, creation of an acid-base resistance zone,steps to optimise the performance of all-in-one adhesives, and incremental placement of direct composite resin to improve bond strengths to cavity floor dentine. It explores how understanding the phenomenon of colour-shifting at the composite resin-enamel/dentine restoration borders can help in creating near "invisible" restoration margins through a "chameleon" effect. With the increased risks of transmission of Covid-19 when aerosol generating procedures are carried out in Dentistry, following a minimally invasive approach to managing dental caries should be given serious consideration.