Understanding the Meat-Masculinity Link: Traditional and Non-Traditional Masculine Norms Predicting Men's Meat Consumption.

Conformity to masculinity ideology predicts men's meat consumption and willingness to reduce their meat intake, but it is unknown which specific masculine norms account for these relationships. This study investigated which traditional and non-traditional masculine norms predict meat consumption, red and processed meat consumption, and willingness to reduce meat consumption in 557 Australian and English males. Men who support the use of physical violence and place high importance on sex ate more meat. Willingness to reduce was highest among men with gender egalitarian views. Targeting these specific masculine norms may be important for mitigating men's overconsumption of meat.

Effects of physical exercise, LEGO, and Minecraft activities on anxiety in underserved children with autism: Study design and methodological strategies.

Anxiety is a common comorbidity for individuals with ASD, and there is some preliminary data about the efficacy of physical exercise to alleviate anxiety. However, we are not aware of any studies that have compared the effects of a physical exercise program on anxiety in underserved children with ASD using a randomized controlled research design. This paper describes a method to evaluate and compare the efficacy of an 8-week physical exercise intervention with a sedentary play intervention to alleviate anxiety in young children with autism spectrum disorders (ASD) from underserved backgrounds. We assessed anxiety and its physical symptoms using the parent-rated Child Behavior Checklist DSM-5 anxiety (CBCL DSM-5) subscale, the child-rated Screen for Childhood Anxiety Related Emotional Disorder (SCARED), the parent-rated Child's Sleep Habits Questionnaire (CSHQ), and salivary cortisol. We also utilized the Physical Activity Questionnaire for Older Children (PAQ-C) to assess physical activity level and identify compounds. Unique components of this study include: •Implementation of novel physical exercise and sedentary play interventions that have been designed for children with ASD.•Recruitment of predominantly underserved and non-English speaking families.

Awareness of alcohol as a breast cancer risk factor and intentions to reduce alcohol consumption among U.S. young adult women.

Alcohol consumption is prevalent in young adult women and linked with breast cancer risk. Research to inform interventions targeting alcohol consumption as a breast cancer prevention strategy is limited. We examined young women's awareness of alcohol use as a breast cancer risk factor, identified correlates of awareness, and determined how awareness and conceptual predictors relate to intentions to reduce drinking. Women aged 18-25 years who drank alcohol in the past month (N = 493) completed a cross-sectional survey. Measures captured sociodemographics, breast cancer risk factors, awareness of alcohol use as a breast cancer risk factor, intentions to reduce drinking, and conceptual predictors. Analyses examined correlates of awareness and associations between awareness, conceptual predictors, and intentions to reduce drinking. Awareness was low (28%) and intentions to reduce drinking were moderate (M = 2.60, SD = 0.73, range 1-4). In multivariable analyses, awareness was associated with greater worry about cancer, beliefs that there's not much one can do to reduce cancer risk and everything causes cancer, higher perceived breast cancer risk, and stronger beliefs that reducing drinking reduces breast cancer risk. Awareness was not associated with intentions to reduce drinking. Younger age, older age of alcohol initiation, negative attitudes towards alcohol, fewer friends consuming alcohol, and stronger self-efficacy were associated with intentions to reduce drinking. Few young women recognize alcohol consumption as a breast cancer risk factor. Researchers and policymakers can apply our findings to design new or refine existing interventions to optimize their impact on awareness and alcohol consumption in young women.

Alcohol use is common among young adult women and is linked to an increased risk of breast cancer later in life. This study aimed to identify factors linked to young women's awareness of alcohol as a breast cancer risk factor and factors linked to intentions to reduce drinking. We surveyed 493 women aged 18­25 who resided in Ohio and reported drinking alcohol in the past month. Only 28% of the women were aware that alcohol use increases breast cancer risk, and intentions to reduce drinking were moderate. Factors associated with awareness of alcohol use as a breast cancer risk factor included cancer worry, believing there's not much you can do to lower your risk of cancer, believing everything causes cancer, higher perceived risk of breast cancer, and stronger beliefs that drinking less reduces breast cancer risk. Factors linked to intentions to reduce drinking included younger age, older age at first drinking, more negative attitudes about alcohol, believing fewer friends drink, and higher confidence to reduce drinking. The findings can help researchers and policymakers create new interventions to educate young women about the link between alcohol consumption and breast cancer risk and reduce alcohol use as a breast cancer prevention strategy.

Does Thinking in Opposites in Order to Think Differently Improve Creativity?

In this paper, we focus on the link between thinking in opposites and creativity. Thinking in opposites requires an intuitive, productive strategy, which may enhance creativity. Given the importance of creativity for the well-being of individuals and society, finding new ways to enhance it represents a valuable goal in both professional and personal contexts. We discuss the body of evidence that exists concerning the importance of the first representation of the structure of a problem to be solved, which determines the baseline representation and sets limits on the area within which a problem solver will explore. We then review a variety of interventions described in the literature on creativity and insight problem solving that were designed to overcome fixedness and encourage people to move away from stereotypical solutions. Special attention is paid to the research carried out in the context of problem solving, which provides evidence that prompting people to "think in opposites" is beneficial. We suggest that an extended investigation of the effects of this strategy in various types of tasks related to creativity is an interesting line of research to follow. We discuss the rationale supporting this claim and identify specific questions, both theoretical and methodological, for future research to address.

Interventions to reduce the stigma of mental health at work: a narrative review.

BACKGROUND: While there are reviews of the literature on mental health stigma reduction programs, very few have focused on the workplace. OBJECTIVE: We sought to identify, describe and compare the main characteristics of the interventions to reduce the stigma towards mental health at work. METHOD: The search of original articles (2007 to 2022) was carried out in the Web of Science Core Collection and Scopus databases, selecting 25 articles from the key terms: 1. Stigma, 2. Workplace, 3. Anti-stigma intervention/program, 4. Mental health. RESULTS: These interventions can be effective in changing the knowledge, attitudes, and behaviors of workers towards people with mental health problems, although further verification of these results is needed as they are limited to date. DISCUSSION AND CONCLUSION: Interventions to reduce stigma in the workplace could create more supportive work environments by reducing negative attitudes and discrimination and improving awareness of mental disorders.

Consumer intentions to reduce food waste in all-you-can-eat restaurants based on personal norm activation.

Norm activation theory (NAT) is a theoretical foundation often used by academics to explain behavioral intention in the context of pro-environmental consumer behavior. This research aimed to analyze the essential role of NAT in ascertaining consumer intentions to reduce food waste based on social marketing. The unit of analysis was an individual, namely consumers who have visited an "all-you-can-eat" restaurant in the last month during the research time and intend to visit again in the future. Primary data was collected using a questionnaire instrument which was created and distributed online. Furthermore, the Likert scaling technique with five answer options was used to measure each item of the latent variable measurement. This research used purposive sampling with a size of 500 respondents, and the quality of the measurement was tested using confirmatory factor analysis. The covariance-based structural equation modeling (SEM) technique was used to test the hypotheses. The results showed that personal norm as the core of NAT can be active when consumers feel they are responsible for the negative impacts of food waste. Active personal norm has a significant effect on behavioral intentions and the formation of consumer intentions to reduce food waste. Contextually, the implementation of NAT to reduce food waste with a focus on the social marketing approach is the essential originality of this research. Further research will be more comprehensive if it involves actual behavioral factors as a translation of intentions.

Interventions to reduce the stigma of mental health at work: a narrative review

Abstract Background While there are reviews of the literature on mental health stigma reduction programs, very few have focused on the workplace. Objective: We sought to identify, describe and compare the main characteristics of the interventions to reduce the stigma towards mental health at work. Method The search of original articles (2007 to 2022) was carried out in the Web of Science Core Collection and Scopus databases, selecting 25 articles from the key terms: 1. Stigma, 2. Workplace, 3. Anti-stigma intervention/program, 4. Mental health. Results: These interventions can be effective in changing the knowledge, attitudes, and behaviors of workers towards people with mental health problems, although further verification of these results is needed as they are limited to date. Discussion and conclusion Interventions to reduce stigma in the workplace could create more supportive work environments by reducing negative attitudes and discrimination and improving awareness of mental disorders.

Reduction with Pre-Drilling Combined with a Finger Reduction Tool in Difficult-to-Reduce Intertrochanteric Fracture.

OBJECTIVE: To investigate the feasibility of pre-drilling combined with a finger reduction tool for the reduction of difficult-to-reduce intertrochanteric fractures. METHODS: Patients diagnosed with complicated intertrochanteric fractures during the period from July 2016 to May 2021 at the Affiliated Hospital of our College were enrolled in this study. All patients underwent reduction by pre-drilling combined with a finger reduction tool followed by fixing with proximal femoral nail antirotation. The outcome of reduction was evaluated by intraoperative fluoroscopy. The operation time, intraoperative fluoroscopy frequency, and incidence of postoperative complications (including infection in the incision area, coxa vara, nail withdrawal, nail breakage, blade cut-out, lower limb vein thrombosis, and pulmonary embolism) were recorded to evaluate the speed of the operation, the difficulty of the operation, and the prognosis of the patient, respectively. The Harris hip score at 9 months after surgery was used to evaluate the hip recovery. RESULTS: A total of 52 patients (17 men and 35 women), 61-88 (77.54 ± 7.40) years of age were included in the study. There were 14 patients with cardiovascular or cerebrovascular disease, ten patients with diabetes, three patients with Parkinson's disease, and three patients with respiratory diseases. The fractures included in the study were classified according to the Orthopedic Trauma Association 31 classification system as type A2.2 (n = 36) or type A2.3 (n = 16). The time from injury to surgery was 1-11 (3.35 ± 1.78) days, and the operation time ranged 31-101 (65.67 ± 14.17) min. The intraoperative blood loss ranged from 40 to 100 (67.69 ± 18.24) mL, and the number of intraoperative fluoroscopy images obtained was 12 to 32 (20.42 ± 5.27). The Harris hip score at 9 months after surgery ranged from 84 to 94 (90.06 ± 2.15). Patients were followed for 9-16 (10.63 ± 1.61) months. One patient died of acute myocardial infarction at 9 months after surgery. One patient suffered from nail withdrawal 5 months post-operation and thus underwent hemiarthroplasty. CONCLUSIONS: Satisfactory reduction can be achieved using a pre-drilling femoral trochanter combined with a finger reduction tool for the management of difficult-to-reduce complex intertrochanteric fractures. This technique does not increase surgical trauma and also reduces the dose of radiation administered to the patient.

HbA1c, Coronary atheroma progression and cardiovascular outcomes.

BACKGROUND AND AIMS: We tested the hypothesis that on-treatment HbA1c levels independently associate with coronary atheroma progression and major adverse cardiovascular events (MACE: death, myocardial infarction, cerebrovascular accident, coronary revascularization, or hospitalization for unstable angina) rates. METHODS: We performed a post-hoc pooled analysis of data from seven prospective, randomized trials involving serial coronary intravascular ultrasonography (IVUS). The percent atheroma volume (PAV) was calculated as the proportion of the entire vessel wall occupied by atherosclerotic plaque. Using multivariable mixed modeling, we determined the association of on-treatment HbA1c with annualized change in PAV. Cox proportional hazard models were used to assess the association of HbA1c with incidence of MACE. RESULTS: Among 3,312 patients (mean age 58.6±9years, 28.4%women) average on-treatment HbA1c was 6.2±1.1%. Overall, there was no net significant annualized change in PAV (0.12±0.19%, p = 0.52). In a fully adjusted multivariable analysis (following adjustment of age, sex, body mass index, systolic blood pressure, smoking, low- and high-density lipoprotein cholesterol, triglyceride levels, peripheral vascular disease, trial, region, and baseline PAV), higher on-treatment HbA1c levels were independently associated with annualized changes in PAV [beta-estimate (95% confidence interval): 0.13(0.08, 0.19), p < 0.001]. On-treatment HbA1c levels were independently associated with MACE [hazard ratio (95% confidence interval): 1.13(1.04, 1.23), p = 0.005]. CONCLUSIONS: Independent of achieved cardiovascular risk factor control, greater HbA1c levels significantly associate with coronary atheroma progression rates and clinical outcomes. These results support the notion of a direct, specific effect of glycemic control upon coronary atheroma and atherosclerotic events, supporting the rationale of therapies designed to directly modulate it.

Restaurant customers' food leftover reduction intention derived from nature connection and biospheric values: A comparison between men and women.

As the COVID-19 pandemic extends over a long period of time, the World Food Programme (WFP) estimated that food insecurity would take place in the near future. Previous studies focused on various kinds of interventions for food waste prevention. Surprisingly, however, research tackling consumer attitudes and behaviors as a way to reduce food waste is still rare. To fill this gap in the literature, this study examined the antecedent roles of restaurant customers' nature connection and biospheric values in fostering their food leftover reduction intention through environmental self-identity and sense of obligation to reduce food leftover. In addition, the moderating effects of gender were tested on all the relationships in our conceptual model. A quantitative approach with an online survey for restaurant customers was adopted. Structural equation modeling was adopted to analyze the data. Through confirmatory factor analyses, the adequate reliability and validity of the measures were established. All the relationships between the constructs were found to be significant, supporting the hypotheses. In other words, the restaurant customers' nature connection and biospheric values were found to eventually induce the customers' food leftover reduction intention. In addition, in terms of the moderating effect, the male customers' nature connection more strongly increased their biospheric values than the female customers' case. The findings of this study revealed how restaurant customers' food leftover reduction intention is formed through their feeling of oneness with nature and biospheric values. Given that consumer behavior has been recognized as a major driver of restaurant food waste, the findings of this study provide useful insights to restauranteurs and policymakers for the health of society and people in it. It was especially true for men in that their feeling of oneness with nature significantly influences their biospheric values more than women's.

Feasibility of Risk Reducing Salpingo-Oophorectomy at the Time of Abdominal Surgery for Correction of Pelvic Organ Prolapse and Urinary Incontinence.

OBJECTIVE: The objective of this study is to assess the perioperative outcomes when prophylactic bilateral salpingo-oophorectomy (BSO) is performed concomitantly with surgery to repair pelvic organ prolapse (POP) or stress urinary incontinence (SUI). MATERIALS AND METHODS: This is a retrospective case-control study of patients who underwent abdominal surgery for the correction of POP and/or SUI with or without concomitant BSO at a tertiary care center. The primary outcome measures were postsurgery length of hospitalization, estimated blood loss, and 30-day readmission rate. The secondary outcome measure was detection of ovarian cancer precursor lesions. RESULTS: We identified 734 patients who had surgery for POP and/or SUI. The control group contained 385 patients, and the BSO group contained 349 patients. There was no difference between the control and BSO groups in the postsurgery length of stay (LOS) (35.2 h vs. 34.1 h; P = 0.49), and all-cause 30-day readmission rate (14.2% vs. 11.6%; P = 0.3085). However, there was decreased blood loss (40.8 ml vs. 67.2 ml, P < 0.0001) in the BSO group compared to the control group. Sub-analysis of primary outcomes in postmenopausal women (age > 55) showed decreased postsurgery LOS (33.4 h vs. 37.4 h; P = 0.0208) and decreased blood loss (35.9 ml vs. 82.7 ml; P < 0.0001) in the BSO group compared to control. CONCLUSION: Secondary to the lack of additional complications, we recommend surgeons give more consideration to finding appropriate candidates for a risk reducing BSO at time of abdominal surgery to repair POP or SUI.

How will the greening policy contribute to China's greenhouse gas emission mitigation? A non-parametric forecast.

On March 24, 2015, a political bureau meeting of the Communist Party of China Central Committee first proposed the political task of "greening" and placed unprecedented importance on the construction of an ecological civilization, aiming to guide China's economy and society toward green and low carbon development. This study aims to examine the impact of this "greening" policy on China's climate change mitigation. First, from an emissions reduction perspective, this study interprets greening as the process of constantly strengthening society's awareness and willingness regarding emissions reduction. Then, this study incorporates a carbon abatement willingness factor into a nonparametric model, and quantitatively simulates the impact of greening on carbon dioxide (CO2) emissions reduction in China. The results show that China can rapidly decrease its CO2 emissions in the early stages of greening. However, when greening passes a certain stage, it no longer affects CO2 emissions. Thus, the willingness to reduce emissions has a diminishing marginal effect on emissions reduction. Additionally, throughout the greening process, China is expected to reduce its CO2 emissions by 36.08%, or 3718.50 million tons. Finally, the impact of greening on China's CO2 emissions exhibits spatial variation, as its undeveloped western region can achieve greater CO2 emissions reductions by promoting greening. Base on the above results, corresponding policy implications are also provided at the end of this paper.

Salpingectomy vs tubal ligation for sterilization: a systematic review and meta-analysis.

OBJECTIVE: After strong evidence and major organizations recommending salpingectomy over tubal ligation, we sought to perform a systematic review and meta-analysis comparing the intraoperative attributes and complication rates associated with these 2 procedures. DATA SOURCES: We searched PubMed, the Cochrane Library, Embase, and clinical trials registries without time or language restrictions. The search was conducted in February 2020. Database searches revealed 74 potential studies, of which 11 were examined at the full-text level. Of these, 6 studies were included in the qualitative analysis and 5 studies were included in the meta-analysis. STUDY ELIGIBILITY CRITERIA: We included randomized controlled trials comparing salpingectomy with tubal ligation in women seeking sterilization. We included studies that also had at least 1 outcome listed in the population/patient problem, intervention, comparison, outcome, and time. Articles were excluded if they did not meet the inclusion criteria or if data were not reported and the authors did not respond to inquiries. STUDY APPRAISAL AND SYNTHESIS METHODS: Abstracts and full-text articles were assessed by 2 authors independently using the blinded coding assignment function or EPPI-Reviewer 4. Conflicting selections were resolved by consensus. The quality of included studies was determined using the Cochrane Collaboration tool for assessing the risk of bias in randomized trials. Two authors independently assessed the risk of bias for each study; disagreements were resolved by consensus. RESULTS: There were few differences between the procedures, with no differences in most important clinical outcomes (antimüllerian hormone, blood loss, length of hospital stay, pre- or postoperative complications, or wound infections). A single study reported a reduced rate of pregnancies with salpingectomy (risk ratio, 0.22; 95% confidence interval, 0.05-1.02), but this did not reach statistical significance (P=.05). CONCLUSION: We conclude from these data that salpingectomy is as safe and efficacious as tubal ligation for sterilization and may be preferred, where appropriate, to reduce the risk of ovarian cancer.

Does cumulative exposure to traumatic stressors predict treatment outcome of community-implemented exposure-based therapy for PTSD?

Background: Posttraumatic Stress Disorder (PTSD) is associated with high levels of functional impairments such as difficulties in academic or occupational performance and in social relationships. With an increasing number of traumatic event types experienced (trauma load), PTSD risk increases in a dose-dependent manner. Accordingly, high rates of PTSD can impair the reconstruction process in post-conflict societies. In order to meet these high needs for mental health services in societies with little access to professional care, task shifting approaches and community-based interventions have been suggested. Narrative Exposure Therapy (NET) has been developed as a short and pragmatic exposure-based PTSD treatment that can be easily trained to lay personnel. Yet, it remains unclear whether NET can be effectively provided by trained lay counsellors even at high levels of trauma load. Objective: To investigate whether trauma load influences the treatment effectiveness of NET provided by trained and supervised local lay counsellors. Method: Linear mixed models were calculated to investigate the influence of trauma load on treatment effectiveness in a sample of N = 323 rebel war survivors from Northern Uganda with PTSD. Results: We found a strong reduction of PTSD symptoms following NET, which was not influenced by trauma load. However, individuals with higher levels of trauma load reported higher PTSD symptoms before therapy as well as 4 and 10 months following treatment completion compared to individuals with lower trauma load. Conclusions: Treatment with NET by lay counsellors is effective independent of trauma load. However, individuals with higher trauma load have a higher probability to show residual symptoms, which might require additional time, sessions or treatment modules.

Antecedentes: El trastorno de estrés traumático (TEPT) se asocia con altos niveles de discapacidad funcional, tales como dificultades en el desempeño académico uocupacional yen las relaciones sociales. Con un número creciente de los tipos de eventos traumáticos experimentados (carga traumática), el riesgo de TEPT aumenta en una forma dependiente de la dosis. De la misma forma, altas tasas de TEPT pueden afectar el proceso de reconstrucción en las sociedad post-conflicto. Para abordar estas crecientes necesidades por servicios de salud mental en sociedades con poco acceso acuidado profesional, se ha sugerido el enfoque de cambio de tareas ylas intervenciones basadas en la comunidad. La Terapia de Exposición Narrativa (NET en su sigla en inglés) ha sido desarrollada como un tratamiento de TEPT basado en la exposición, breve ypragmático que puede ser fácilmente entrenado al personal laico. Aun así, permanece incierto si la NET puede ser implementada efectivamente por consejeros laicos entrenados, incluso aaltos niveles de carga traumática.Objetivo: Investigar si la carga traumática influencia la efectividad del tratamiento de la NET proporcionado por consejeros laicos locales entrenados ysupervisados.Método: Los modelos mixtos lineales se calcularon para investigar la influencia de la carga traumática en la efectividad del tratamiento, en una muestra de N= 323 sobrevivientes de guerra rebelde desde Uganda del Norte con TEPT.Resultados: Encontramos una clara reducción de los síntomas TEPT luego de la NET, la cual no fue influenciada por la carga traumática. Sin embargo, los individuos con altos niveles de carga traumática reportaron altos niveles de síntomas TEPT antes de la terapia como también 4 y 10 meses luego del término del tratamiento comparado alos individuos con carga traumáticamás baja.Conclusiones: El tratamiento con la NET administrada por consejeros laicos es efectiva independiente de la carga traumática. Sin embargo, los individuos con carga traumáticamás alta tienen una probabilidadmás alta de mostrar síntomas residuales, los cuales podrían requerir tiempo, sesiones omódulos de tratamiento adicionales.

External ventricular drain related complications-whether continuous csf drainage via ommaya reservoir is the answer?

BACKGROUND AND AIMS: External ventricular drainage (EVD) is one of the commonest procedures in neurosurgical practice to manage acute hydrocephalus. We evaluated the infectious and non-infectious complications associated with a modified technique for EVD using an Ommaya reservoir. METHODS: Ommaya reservoir was placed in all patients who required EVD placement for CSF drainage. CSF drainage was achieved using a needle placed in a non-coring fashion percutaneously into the Ommaya reservoir to achieve CSF drainage externally. CSF was monitored for signs of infection regularly using CSF biochemistry and cultures. CSF infection was defined by a positive culture or a secondary infection in patients with already infected CSF. RESULTS: 59 patients required continuous CSF drainage during the study period from January 2014 to June 2017. 46 (77.96%) patients had non-infected CSF at time of starting drainage and 13 (22.03%) patients required external CSF drainage for primarily infected CSF. The study period had a total of 793 CSF drainage days (Range 3-64 days) with an average of 13.4 days per patient. The cumulative rate of new infection was 5.08%. No ventricular catheter blockage or dislodgement was seen in any of the patients. CONCLUSIONS: External ventricular drainage through an Ommaya chamber is a safe and effective method and can be used to reduce the catheter related complications like infection, catheter blockage and dislodgement.

Community stakeholders' views on reducing violence against women in Pakistan.

BACKGROUND: Nearly half of the women experience violence across their lifespan in all the provinces of Pakistan at an alarming rate. Despite knowing the prevalence, there has been meager progress in developing strategies to combat violence at individual, family, or community level. Many interventions suggested in other countries have been pilot tested but the effects of those interventions had been limited. Therefore, the aim of this study is to understand the voices of stakeholders to reduce Violence Against Women (VAW) and to explore the possible community-based strategies that could be implemented in Pakistan. METHODS: A total of 14 Key Informant Interviews (KIIs) and 18 Focus Group Discussions (FGDs) were held across all four provinces of Pakistan. Participants were purposefully recruited and all the interviews were audio-recorded. Transcriptions were open coded and content analysis was done to emerge codes, categories and themes. Ethical approval was obtained from Aga Khan University Ethics Review Committee. RESULTS: Three major themes emerged on community members and stakeholders' views on VAW: a) community's perception of VAW b) the repercussions of VAW, and c) multiple voices regarding strategies to reduce VAW. Participants voiced the need of standing against the status quo, role of awareness and education: regarding capacity building skills, promotion of women rights and women empowerment through Life Skills Based Education (LSBE) through national health works program, has been proposed as an innovative strategy to reduce VAW. CONCLUSIONS: The responsibility to bring about a substantial change in behavior and attitudes must begin with engaging men in all the interventions that aim to reduce violence. Since, VAW is very much linked with the cultural norms, so, without community stakeholder's involvement and participation it could never be reduced. Keeping the existing socio-cultural dynamics in mind, the need of time is to design and implement innovative interventions that are culturally and contextually appropriate and can be expanded across the country.

Help in hand after traumatic events: a randomized controlled trial in health care professionals on the efficacy, usability, and user satisfaction of a self-help app to reduce trauma-related symptoms.

Background: Despite the fact that many people are affected by trauma and suffer from posttraumatic stress symptoms (PTSS) there is a lack of easy-accessible interventions to self-manage these symptoms. Mobile apps may deliver low-intensity self-help to reduce trauma-related symptoms and empower individuals following trauma, such as high-risk professionals who are regularly exposed to potentially traumatic events. In this randomized controlled trial, we examined the efficacy, and evaluated the usability and user satisfaction of the app 'SUPPORT Coach' as a self-help tool to reduce trauma-related symptoms. Methods: Health care professionals (e.g. nurses, physicians, paramedics and ambulance drivers) completed an online screening on PTSS (T0). They were randomized when at least one PTSS was reported, either to the intervention (1 month unlimited access to SUPPORT Coach) or control condition (no access to SUPPORT Coach). Self-reported PTSS, negative trauma-related cognitions, psychological resilience, and social support were assessed online at baseline (T1), post-condition (T2), and 1 month follow-up (T3). Results: Of the 1175 participants screened, 287 (24.4%) indicated at least one posttraumatic stress symptom and were randomized. The majority of intervention condition participants (83%, n = 103) used SUPPORT Coach; they were slightly to moderately satisfied with the app. There was no significant group difference in change in PTSS and social support after one-month app usage. However, the intervention condition showed a greater decline in negative trauma-related cognitions at T2 and T3, and a larger increase in psychological resilience at T3 than the control condition. Conclusions: SUPPORT Coach without guidance could potentially provide easy-accessible self-help to diminish negative trauma-related cognitions, and strengthen resilience in coping with adversities. However, since the attrition rate was substantially higher in the intervention than in control condition, our findings should be interpreted with caution and warrant replication.

Antecedentes: Pese al hecho de que muchas personas son afectadas por traumas y sufren de síntomas de estrés postraumático (PTSS por sus siglas en inglés) existe una carencia de intervenciones fácilmente accesibles para auto-manejar estos síntomas. Las aplicaciones móviles pueden entregar autoayuda de baja intensidad para reducir los síntomas relacionados con el trauma y empoderar individuos posterior a un trauma, tales como en profesionales de alto riesgo que están regularmente expuestos a eventos potencialmente traumáticos. En este ensayo controlado randomizado examinamos la eficacia, y evaluamos la usabilidad y satisfacción de la aplicación 'SUPPORT Coach' como una herramienta de autoayuda para reducir síntomas relacionados con el trauma.Métodos: Profesionales de atención en salud (como enfermeras, médicos, paramédicos y conductores de ambulancia) completaron un tamizaje online de PTSS (T0). Fueron randomizados cuando al menos un PTSS fue reportado, ya sea a la intervención (un mes de acceso ilimitado a SUPPORT Coach) o a control (sin acceso a la aplicación). Se evaluó el auto-reporte de PTSS, cogniciones negativas relacionadas al trauma, resiliencia psicológica y apoyo social basalmente (T1), post condición (T2) y un seguimiento al mes de la intervención (T3).Resultados: de los 1175 participantes tamizados, 287 (24.4%) indicaron al menos un síntoma de estrés postraumático y fueron randomizados. La mayoría de los participantes del grupo de la intervención usaron SUPPORT Coach (83% n=103), y se encontraron de leve a moderamente satisfechos con la aplicación. No hubo diferencia significativa entre los grupos en PTSS y en apoyo social después de un mes de haber utilizado la aplicación. Sin embargo, el grupo que recibió la intervención mostró una mayor declinación en cogniciones negativas relacionadas con el trauma en T2 y T3, y un mayor aumento de la resiliencia psicológica en T3 que en el grupo control.Conclusiones: El uso de SUPPORT Coach sin guía podría potencialmente proveer autoayuda fácilmente accesible para disminuir cogniciones negativas relacionadas con el trauma, y fortalecer la resiliencia al lidiar con adversidades. Sin embargo, dado que la tasa de deserción fue sustancialmente más alta en el grupo de intervención que en el de control, nuestros hallazgos debiesen ser interpretados con cautela y justifican replicación.

Disparities in Access to Oral Health Care.

In the United States, people are more likely to have poor oral health if they are low-income, uninsured, and/or members of racial/ethnic minority, immigrant, or rural populations who have suboptimal access to quality oral health care. As a result, poor oral health serves as the national symbol of social inequality. There is increasing recognition among those in public health that oral diseases such as dental caries and periodontal disease and general health conditions such as obesity and diabetes are closely linked by sharing common risk factors, including excess sugar consumption and tobacco use, as well as underlying infection and inflammatory pathways. Hence, efforts to integrate oral health and primary health care, incorporate interventions at multiple levels to improve access to and quality of services, and create health care teams that provide patient-centered care in both safety net clinics and community settings may narrow the gaps in access to oral health care across the life course.

Health-care mechanism and medicine and food resources of invigorating spleen in traditional Chinese medicine / 中草药

According to the theory of traditional Chinese medicine (TCM), spleen and stomach are the most important visceral system to maintain human life and health, and healthy spleen and stomach can help to nourish the primordial qi, so as to maintain sufficient vitality of the body. Therefore, invigorating the spleen plays an important role in the prevention and recovery of human diseases. In this paper, the correlation between the theory of invigorating the spleen of TCM and the function of modern health care was discussed, and the relationship between spleen invigorating and digestive tract protection, immunomodulation, anti-oxidation, relieving physical fatigue, helping to reduce fat and lose weight, improving sleep and other modern health care functions and its mechanism were systematically summarized and analyzed. The mechanism and material basis of important spleen-invigorating Chinese medicinal materials such as Astragalus membranaceus, Poria cocos, Dioscorea opposita, Euryale ferox, Atractylodes macrocephala and Polygonatum sibiricum and classic recipe of invigorating spleen such as Guipi Decoction, Sijunzi Decoction, Buzhong Yiqi Decoction and Lizhong Decoction were briefly reviewed, in order to provide some new ideas and methods for the development and utilization of spleen-invigorating medicine and food resources in TCM and the research and development of TCM health food.

Reducción de la exposición en residentes de Cirugía frente al brote de COVID-19 / Reduction of exposure in residents of Surgery in face of the outbreak of COVID-19

El brote mundial de COVID-19 durante el primer trimestre de 2020 constituye un desafío sin precedentes para el sistema de salud. El objetivo es describir las estrategias adoptadas por los residentes de Cirugía General de un Hospital Universitario de la Argentina, para salvaguardar la salud de los residentes, reducir el riesgo de exposición de los pacientes quirúrgicos, mantener la formación académica continua y fomentar el trabajo en equipo. Minimizar la exposición de los residentes dividiendo el personal total en dos equipos que trabajan por quincenas; dividir las actividades, las horas dentro del hospital y los turnos por igual entre los residentes; usar telemedicina para controles posoperatorios/ ambulatorios; suspender la actividad de consultorio; organizar clases diarias en línea y revisiones de artículos publicados. En el contexto de la pandemia de COVID-19 se deben utilizar todos los medios para minimizar el riesgo de exposición para así optimizar los recursos humanos. A pesar de que estas estrategias pueden aplicarse fácilmente a otras residencias, se necesita más investigación para evaluar su impacto en la transmisión de enfermedades, y en la salud física y emocional de los profesionales de la salud.

The worldwide outbreak of COVID-19 during the first quarter of 2020 constitutes an unprecedented challenge for the health system. The aim is to describe the strategies adopted by residents of General Surgery of a university hospital of Argentina, to safeguard the health of residents, reduce the risk of exposure of surgical patients, maintain continuous academic training and promote teamwork. Minimize resident exposure by dividing the group into two teams that work by fortnights; divide activities, hours within hospital, and shifts equally among residents; use telemedicine for postoperative / ambulatory controls; suspend office activity; organize daily online classes and reviews of published articles. In the context of the COVID-19 pandemic, all means should be used to minimize the risk of exposure in order to optimize human resources. Although these strategies can easily be applied to other residencies, more research is needed to assess their impact on disease transmission, and on the physical and emotional health of health professionals.