Psychosocial interventions and strategies to support young people at mass gathering events: a scoping review.

OBJECTIVES: To improve health and safety outcomes at mass gathering events (MGEs) for young attendees, it is essential to understand the psychosocial factors that may influence behaviour so that the implementation of support strategies before, during and after MGEs can be developed to enhance outcomes. This review identifies the psychosocial outcomes that may occur at MGEs, including social connection, substance use, risky behaviours and psychological distress and examines what interventions have been implemented to target these outcomes. STUDY DESIGN: Scoping review. METHODS: This study examined MGE psychosocial interventions with predominantly youth attendees was conducted using the Preferred Reporting Items of Systematic reviews and Meta-Analysis extension for Scoping Reviews guidelines. Papers were collected from the databases CINAHL, MEDLINE, Embase and PsycINFO. Titles and abstracts were scanned for relevance, followed by a full-text screening. Information relevant to the research question was extracted from papers meeting the inclusion criteria. RESULTS: Twenty-six papers met the inclusion criteria. The psychosocial factors that were most studied included social influence, social interactions and psychological stressors, which lead to behaviours such as excessive alcohol consumption, drug taking, risky casual sex and risk taking amongst psychological factors of young attendees. Effective interventions implemented before or during MGEs, such as alcohol-free zones, antidrinking campaigns, psychoeducation and disapproval from parents with regard to drinking alcohol, showed promise in reducing harms. CONCLUSION: Psychosocial interventions have the potential to reduce harms and enhance well-being for young people attending MGEs. This review has identified gaps and opportunities in the current literature with regard to psychosocial interventions and strategies to support young people at MGEs and makes recommendations to support the development and refinement of evidence-based interventions aimed at young MGE attendees.

Why time matters when it comes to resilience: how the duration of crisis affects resilience of healthcare and public health leaders.

The meaning of time, especially in crisis, where situations are likely to become even more complex, uncertain, and disruptive, is crucial. Incorporating previous research on organizational crises, organizational resilience, extreme context, and individual resilience, we know that leaders do play a crucial role when it comes to handle adversity in organizations but also that leaders might influence organizational resilience and employee resilience. Intensified by the COVID-19 pandemic, the leaders' ability to effectively deal with a critical situation becomes even more important in healthcare organizations. We argue that time is not only important when it comes to crisis management but also that it is highly significant when it comes to leaders' resilience. Considering the aspect of time implies that different temporal demands, especially regarding the persistence of adversity, require different resilience strategies applied by the leader. Therefore, we call for future research on examining how different leaders' resilience strategies (short term vs. long term) affect crisis management outcomes as well as the resilience in healthcare and public health organizations.

Crisis leadership: a case for inclusion in accredited Master of Public Health program curricula.

OBJECTIVES: To evaluate the exposure to crisis leadership theory already present in Council on Education for Public Health (CEPH) accredited Master of Public Health (MPH) programs in the United States and provide a compelling case for its future inclusion. STUDY DESIGN: This was a narrative review. METHODS: We compiled a comprehensive list of 179 CEPH schools that offered an MPH program. During January through March 2021, we examined 179 websites for the core courses and elective courses offered in the MPH degree program to determine if any courses covered the topics of leadership, crisis leadership, or crisis management in either the course title or description. RESULTS: Leadership courses were available in only 55.31% of CEPH-accredited schools. Only a single program (0.56%) offers a crisis leadership course. CONCLUSIONS: The current global COVID-19 pandemic and reality of climate-induced disasters have brought crises to the forefront for health systems. Successful leadership for the future requires public health leaders to have training in crisis leadership. The evaluation and revision of public health curricula must focus on leadership competency development to prepare graduates to lead complex multiple crisis events and system shocks simultaneously.

[Kearns-Sayre syndrome]. / Kearns-Sayre-szindróma.

The authors describe a rare group of symptoms, resulting in progressive external ophthalmoplegia, retinal pigment epithelial dysfunction and cardiac conduction disturbance. The illness belongs to the group of mitochondrial cytopathies. The case extends over the diagnostic possibilities, with special attention on electromyographic diagnostic, clinical symptoms, pathomechanism of the disease, and the therapic possibilities.

[A case of herpes simplex encephalitis requiring surgical management]. / Herpes simplex encephalitis mütéti kezelést igénylö esete.

The authors report about surgical treatment of herpes simplex encephalitis, although conservative management of this disease is the method of choice in the first place. They draw a lesson from this case that certain cases of large space occupying lesions of infectious origin leading to brain stem compression may require surgical management, even if they customary treatment is conservative.

[Management of polycystic liver by cyst puncture and alcoholic sclerosing]. / Polycytás máj kezelése cystapunctióval és alkoholos sclerotisatióval.

A case of a 51-year-old female suffering in polycystic liver disease is presented. The patient had bulging upper abdomen, pain in the right subcostal region originating perhaps from the stretching liver capsule and a considerably shortened prothrombin time. Only minor portions of liver tissue could be detected by imaging methods, therefore surgical solution was not suggested. In order to maintain the hepatic function by reducing the compression of the functioning tissue, US-guided multiple cyst punctures were performed with sclerotisation of the cysts. Following the multi-stage procedures the size of liver decreased, the hepatic function gradually improved. In accordance with the literature the authors recommend the multi-stage cyst puncture and sclerotisation as beneficial therapy of polycystic liver disease with minor risk, without burden general anesthesia and minimal on the patients.

[Total gastrectomy with esophageal exclusion following corrosive injury to the upper gastrointestinal tract]. / Oesophagus kirekesztéssel végzett total gastrectomia a felsö gastrointestinalis tractus korrozív sérülése után.

A case report of a young male patient is demonstrated who has drunk hydrochloric acid with intention of suicide. Because of an extensive necrosis of the stomach, total gastrectomy with double exclusion of the esophagus and with jejunostomy was performed as an acute intervention. 6 weeks after the acute operation, a successful esophagojejunal bypass was carried out using the right colon. It is well-known from the literature that a mucocele can develop in the excluded esophagus after such an operation. In some cases the mucocele causes compression signs. For this reason, a regular control of these patients is suggested.

[Diagnostic imaging of the subdiaphragmatic lymphatic system in malignant lymphoma: confusion of abundance?]. / A rekesz alatti nyirokrendszer képalkotó diagnosztikája malignus lymphomákban: a böség zavara?

Staging of malignant lymphomas, monitoring of response to therapy and regular follow-up of treated patients can properly be performed by new diagnostic imaging modalities. Diagnosis of subdiaphragmatic nodal involvement by ultrasonography and computed tomography is based on enlargement of lymph nodes. Lymphography is the only method which can depict pathologic internal architecture in normal sized lymph nodes. Of 82 patients there were 72 on admission without known subdiaphragmatic nodal disease. Of these 22 (30.5%) were found to have nodal involvement in this region. Suggested diagnostic algorhythm is shown on flow diagram.

Renal cell carcinoma: value of imaging examinations in diagnosis and staging.

Authors analyse the value of intravenous pyelography, ultrasonography, computed tomography, angiography and fine needle aspiration biopsy in the detection, differentiation and staging of renal space-occupying lesions, on the basis of examinations performed in 158 patients, in comparison with results of surgery and/or clinical follow up. Their conclusion is that ultrasonography plays a major role in the detection and differentiation of these lesions, intravenous pyelography is only a complementary method, while computed tomography can provide diagnosis in cases with uncertain ultrasonographic findings. Staging has to be based on computed tomography. The role of angiography and fine needle aspiration biopsy is limited they need to be performed in a few selected cases only.

Hodgkin's disease in the Waldeyer's ring.

Amongst 128 patients with Hodgkin's disease six were found to have involvement of Waldeyer's lymphoid ring, one in tonsil and five in nasopharynx. Of these, three were histologically verified by biopsies taken from Waldeyer's ring, whilst three had histology only from upper cervical lymph nodes. Disease was confined to head and neck area by five, one had a more widespread process. Discussing diagnostic difficulties of nasopharyngeal involvement the importance of roentgentomography is stressed. Principles of radiotherapy are expounded and a more diligent search for detecting nasopharyngeal disease is proposed.