The effects of alcohol sale bans on children: The case of Russia.

Alcohol control policies are implemented to reduce alcoholism and related harms around the globe. This work examines the effects of a policy that restricted when alcohol could be purchased on child outcomes in Russia. To identify causal impacts, I exploit variation in the timing and severity of the restriction, which was implemented in Russian states between 2005 and 2010. Utilizing household survey data and a difference-in-differences estimation approach, I find that the policy has improved children's physical health, with younger children being more affected, and additionally has decreased a variety of risky behavior indicators. Potential mechanisms for these effects include alcohol consumption, parental employment, household income, family stability, and time use. This work demonstrates that policies controlling parental substance access can have important effects on child health.

Changes in norovirus incidence in Victoria, Australia, 2022: are we back to normal yet after COVID?

Abstract: There were 108 norovirus-positive outbreaks in 2022, with 45 (41.7%) occurring during the first quarter (Q1), January-March. Aged care facilities accounted for 44.4% of norovirus-positive outbreaks; 43.5% were in childcare settings. Overall, the GII.P31/GII.4 genotype was the most common, involved in 39.4% of outbreaks; however, there were shifts in the most common genotype across the year. In Q1, the GII.P31/GII.4 genotype accounted for 73.3% of typed outbreaks, but by Q3 (July-September) the GII.P7/GII.6 was the most prominent genotype at 45.0%. In Q4 (October-December), the dominant genotype had changed again to GII.P16/GII.4 (52.6%). While the incidence of norovirus outbreaks in 2022 was average regarding overall prevalence and genotype diversity, there are still ongoing effects from the coronavirus disease 2019 (COVID-19) pandemic in relation to seasonality, outbreak demographics and specimen referral.

Effects of Short-Term Nighttime Carbohydrate Restriction Method on Exercise Performance and Fat Metabolism.

BACKGROUND: The sleep-low method has been proposed as a way to sleep in a low-glycogen state, increase the duration of low glycogen availability and sleep and temporarily restrict carbohydrates to improve exercise performance. However, long-term dietary restriction may induce mental stress in athletes. Therefore, if it can be shown that the effects of the sleep-low method can be achieved by restricting the carbohydrate intake at night (the nighttime carbohydrate restriction method), innovative methods could be developed to reduce weight in individuals with obesity and enhance athletes' performance with reduced stress and in a shorter duration when compared with those of previous studies. With this background, we conducted a study with the purpose of examining the intervention effects of a short-term intensive nighttime carbohydrate restriction method. METHODS: A total of 22 participants were recruited among university students participating in sports club activities. The participants were assigned at random to groups, including a nighttime carbohydrate restriction group of 11 participants (6 males, 5 females; age 22.3 ± 1.23) who started a carbohydrate-restricted diet and a group of 11 participants (5 males, 6 females; age 21.9 ± 7.9) who continued with their usual diet. The present study had a two-group parallel design. In the first week, no dietary restrictions were imposed on either group, and the participants consumed their own habitual diets. In the second week, the total amount of calories and carbohydrate intake measured in the first week were divided by seven days, and the average values were calculated. These were used as the daily calorie and carbohydrate intakes in the second week. Only the nighttime carbohydrate restriction group was prohibited from consuming carbohydrates after 4:00 p.m. During the two-week study period, all participants ran for one hour each day before breakfast at a heart rate of 65% of their maximum heart rate. RESULTS: The results obtained from young adults participating in sports showed significant differences in peak oxygen consumption (V·O2peak), work rate max, respiratory quotient (RQ), body weight and lean body mass after the intervention when compared with before the intervention in the nighttime carbohydrate restriction group (p < 0.05). CONCLUSIONS: Our findings suggest that the nighttime carbohydrate restriction method markedly improves fat metabolism even when performed for a short period. This method can be used to reduce body weight in individuals with obesity and enhance athletes' performance. However, it is important to consider the intake of nutrition other than carbohydrates.

American Rhinologic Society expert practice statement part 2: Postoperative precautions and management principles following endoscopic skull base surgery.

The goal of this American Rhinologic Society expert practice statement (EPS) is to summarize the best available evidence regarding postoperative precautions for patients following endoscopic skull base surgery for intradural pathology. These topics include the administration of postoperative nasal hygiene; patient mobilization and activity level; the resumption of continuous positive airway pressure in patients with obstructive sleep apnea; and the timing and capacity with which a patient may be subjected to barotrauma, such as air travel postoperatively. This EPS was developed following the recommended methodology and approval process as previously outlined. Given the diverse practices and limited agreement on the accepted principles regarding postoperative precautions for patients following skull base surgery, this EPS seeks to summarize the existing literature and provide clinically relevant guidance to bring clarity to these differing practice patterns. Following a modified Delphi approach, four statements were developed, all of which reached consensus. Because of the paucity of literature on these topics, these statements represent a summation of the limited literature and the experts' opinions. These statements and the accompanying evidence are summarized below, along with an assessment of future needs.

Performance evaluation of facility locations using integrated DEA-based techniques.

Facility location, particularly in the context of international investments by global enterprises, stands out as a paramount concern within the purview of top management's strategic decision-making process. The selection of a suitable location plays a pivotal role in determining the ultimate achievement of organizational objectives. The process of selecting an appropriate location requires the comprehensive analysis of a substantial volume of data, encompassing diverse tangible and intangible evaluation criteria that may exhibit inherent conflicts. This paper addresses the challenge of determining the best location for a manufacturing facility by employing alternative performance measures within the framework of the data envelopment analysis (DEA) model. In a performance evaluation process, not only positive but also negative aspects should be determined. This paper, therefore, proposes a double-frontier DEA-AR model, which is an integrated approach that incorporates the efficient frontier, anti-efficient frontier, and assurance region weight restrictions, with the aim of increasing the discrimination ability of the DEA method. An efficient frontier evaluates the information of each location from a positive viewpoint, while the worst side is evaluated by an anti-efficient frontier. The technique of weight restrictions, which allows incorporating expert opinion into the assessment, is also applied with both frontiers to restrict the regions of weights to some specific area. The prescribed approach is illustrated by a numerical example of selecting the best location among ten different countries under consideration of 22 selection criteria obtained from PEST analysis. The results show that the proposed alternative performance measures significantly improve discrimination capability, enabling the ranking of candidates based on their suitability for the optimal location.

Research on the mechanism of leader-follower product sales competition based on market access restrictions and forward contract considerations.

Market access restrictions have been the focus of attention for various market players, but there are fewer studies on the competitive mechanism of market access restrictions on firms' product sales. This paper investigates the competitive mechanism of leader-follower product sales based on market access restrictions and forward contracts. First, the mechanism of leader-follower sales decisions based on market access restrictions and forward contracts is clarified. Second, it models the forward default risk suffered by followers and the profit rate of leader-follower based on market access restrictions and forward considerations by Bayes' posterior probability method. Moreover, it severely explores the impact mechanisms of the degree of market access restrictions on leaders and followers when followers do not adopt and adopt forwards and makes a simulation analysis. The results show that: (i) When followers do not employ forward contracts, the less restrictive degree of market access increases the supply of leaders, and leaders' competition for product sales further leads to a decrease in the provision of followers. (ii) When followers use forwards, leaders' and followers' expected discounted profit rates decrease with the total supply of products in the market increases. (iii) If the degree of market access restrictions is low, the followers suffer an increased forward default risk, resulting in their rate of revenue decrease. The findings of this paper have some practical significance and policy implications for the regulator to adjust the degree of market access restriction in each restricted access area, to establish a reasonable and efficient competitive environment for product sales, as well as for firms to choose the optimal way of competing for product sales.

Suicidal ideation and suicide attempts among students aged 12 to 24 after the lifting of COVID-19 restrictions in China: prevalence and associated factors.

Objective: To investigate the prevalence and associated factors of suicidal ideation and suicide attempts among adolescent and young adults in China from December 14, 2022 to February 28, 2023, when COVID-19 restrictions were lifted. Methods: Students in middle and high schools and colleges and universities in the province of Sichuan, China were asked to complete on-line cross-sectional surveys. Information was collected about sociodemographics, experiences related to the COVID-19 pandemic, suicidal ideation and suicide attempts. Participants also filled out the Patient Health Questionnaire-9, the Generalized Anxiety Disorder-7 and the Social Support Rate Scale surveys. Factors associated with suicidal ideation or suicide attempts were explored using logistic regression. Results: Of the 82,873 respondents (aged 12 to 24 years), 21,292 (25.7%) reported having thought of suicide at least once in their lifetime, 10,382 (12.5%) reported having thought about suicide within the previous 12 months, and 1,123 (1.4%) reported having attempted it within the previous 12 months. Risk of lifetime suicidal ideation was higher among middle school students than among older students. Risk of suicidal ideation and risk of suicide attempts correlated directly with severity of symptoms of depression and anxiety, and inversely with level of social support. Greater risk of suicidal ideation and suicidal attempts was associated with: being female, living in an urban environment, attending a boarding school, currently being in love, having parents who divorced or remarried, having parents who exhibit non-authoritative parenting behavior, having higher family income, having been COVID-19 infected, having been quarantined for a long time, and being dissatisfied with one's education. Conclusions: Suicidal ideation and suicide attempts remain prevalent among young people in China. The potential associated factors identified in our study may be useful for targeting appropriate psychosocial interventions and developing mental health policies.

COVID-19 Public Health Restrictions and New Mothers' Mental Health: A Qualitative Scoping Review.

Public health restrictions to protect physical health during the COVID-19 pandemic had unintended effects on mental health, which may have disproportionately affected some potentially vulnerable groups. This scoping review of qualitative research provides a narrative synthesis of new mothers' perspectives on their mental health during COVID-19 pandemic restrictions through pregnancy to the postpartum period. Database searches in PubMed, CINAHL, and PsycINFO sought primary research studies published until February 2023, which focused on new mothers' self-perceived mental health during the pandemic (N = 55). Our synthesis found that new mothers' mental health was impacted by general public health restrictions resulting in isolation from family and friends, a lack of community support, and impacts on the immediate family. However, public health restrictions specific to maternal and infant healthcare were most often found to negatively impact maternal mental health, namely, hospital policies prohibiting the presence of birthing partners and in-person care for their infants. This review of qualitative research adds depth to previous reviews that have solely examined the quantitative associations between COVID-19 public health restrictions and new mothers' mental health. Here, our review demonstrates the array of adverse impacts of COVID-19 public health restrictions on new mothers' mental health throughout pregnancy into the postpartum period, as reported by new mothers. These findings may be beneficial for policy makers in future public health emergency planning when evaluating the impacts and unintended consequences of public health restrictions on new mothers.

Nutrition in Gilbert's Syndrome-A Systematic Review of Clinical Trials According to the PRISMA Statement.

Gilbert syndrome is the most common hyperbilirubinemia, associated with a mutation in the UGT1A1 bilirubin gene, which produces an enzyme that conjugates bilirubin with glucuronic acid. Episodes of jaundice occurring in GS negatively affect patients' quality of life. This systematic review aimed to analyze clinical studies regarding nutrition in people with GS. The study followed the PRISMA guidelines and utilized the Ebsco, Embase, Cochrane, PubMed, Scopus, and Web of Science databases to search clinical trials focused on diet/nutrition in GS (1963-2023 years). The methodological quality of selected studies was assessed using the Jadad scale. As a result, 19 studies met the inclusion criteria. The research mainly focused on the impact of caloric restriction, consumption of various diet variants, and vegetables and fruits on hyperbilirubinemia and metabolic health. A nutritional intervention consisting of not applying excessive calorie restrictions and consuming fats and biologically active compounds in vegetables and fruits (Cruciferae, Apiaceous, Rutaceae) may prevent the occurrence of jaundice episodes. It is justified to conduct further research on detecting such compounds in food, which, by influencing the expression of the UGT liver enzyme gene, could contribute to regulating bilirubin concentration in the blood of people with GS.

Stimulating the capacity to govern the commons.

The ability to strengthen governance institutions and fisheries restrictions and laws is needed to improve conservation and management of common-pool resources. We evaluated the potential for stimulating change with modest interventions by studying fishing village households before and after a 27-month intervention period in a high-priority coral reef conservation area. Interventions included training in catch monitoring, stock assessment, mapping fishing grounds, microcredit, gender inclusion, theatrical skills, fuel efficient stoves, and participation in the planning of a conservation proposal. There was a background increase in reported formal education, household size, group membership, and household wealth but a decrease in fish consumption and public services. Of conservation importance, the perceived strength of 13 governance institutions and benefits of 6 fisheries restrictions increased over the intervention period. Finally, correspondence between knowledge of and agreement with recent national fisheries laws was moderate to high and positively correlated. The intervention period was stronger than demographic factors that often influence perceptions, such as village, government services, gender, household size, membership in community groups, and age responses. In general, perceptions of strengths of governance and benefits of restrictions increased more among women and youth than adult men respondents. The largest changes in perceptions of increased benefits were among strict restrictions initially ranked low, specifically fisheries closures, parks, and species restrictions. Consequently, capacity building overrode demographic factors common to poor people with limited employment capacity that can have negative perceptions of strict conservation.

Variabilidad demográfica y escalas de aceptación y rechazo sobre las restricciones en el manejo de recursos Resumen Se necesita de la capacidad para fortalecer a las instituciones de gobierno y las leyes y restricciones a la pesca para mejorar la conservación y manejo de los recursos comunes. Evaluamos el potencial para estimular el cambio con intervenciones modestas con un estudio en los hogares de una aldea pesquera antes y después de un periodo de intervención de 27 meses en un área de conservación de gran prioridad para un arrecife de coral. Las intervenciones incluyeron formación en el monitoreo de las capturas, análisis de stock, mapeo de las zonas de pesca, microcréditos, inclusión de género, habilidades teatrales, estufas ecológicas y participación en la planeación de una propuesta de conservación. Hubo un incremento en el trasfondo de la educación formal reportada, el tamaño del hogar, los miembros del grupo y la riqueza del hogar, pero una disminución en el consumo de pescado y en el servicio público. Fue de importancia para la conservación que la fuerza percibida de 13 de las instituciones de gobierno y los beneficios de seis restricciones a la pesquería incrementaron durante el periodo de intervención. Por último, la correspondencia entre el conocimiento sobre y la aceptación de las leyes recientes de pesca fue de moderada a alta y con una correlación positiva. El periodo de intervención fue más fuerte que los factores demográficos que con frecuencia influyen sobre las percepciones, como las respuestas de los servicios de gobierno, aldea, género, tamaño del hogar, membresía en un grupo comunitario y edad. En general, la percepción de la fuerza de la gobernanza y los beneficios de las restricciones incrementó más entre las mujeres y la juventud que entre los hombres respondientes. Los cambios más grandes en la percepción del aumento en beneficios fueron entre las restricciones estrictas marcadas como bajas al inicio, específicamente el cierre de pesquerías, parques y restricción de especies. Como consecuencia, la formación de capacidad sobrepasó los factores demográficos, que con frecuencia son personas con una capacidad limitada de empleo que pueden tener una percepción negativa de la conservación estricta.

The effect of the exit of an insurer, due to government liquidation, on access to health care: evidence from Colombia.

Our study evaluates the liquidation effect of a health insurer from a subsidized scheme, with the largest number of members in Colombia, on restrictions to future access to user care. Based on the information regarding complaints and judicial claims about healthcare, the effect of this government decision is estimated using a dynamic econometric model of differences in differences. Our results suggest that the liquidation of the Health-Promoting Entity (EPS, its acronym in Spanish) CAPRECOM has a negative effect, specifically, it led to an increase of 0.32 and 0.21 in complaints rates per 1,000 members in the receiving EPSs during the first and second quarters after the intervention, respectively. However, this effect does not persist over time and becomes diluted in the following quarters. There is no evidence of a relationship between the magnitude of the effect and the EPSs performance ranking. Additionally, we do not find significant effects on judicial claims. Our results are important concerning the design and implementation of public policies for EPSs liquidation. We demonstrate the necessity of implementing actions to incorporate guidelines and strategic plans during the transition period. Such actions would enable safeguarding the right to health for the affected population in a liquidation insurer case.

Scurvy: A Rare Disease or a Rare Diagnosis?

Introduction: Scurvy, the disease state caused by ascorbic acid deficiency, was once an extremely common disease but is now thought to be a rare disease in postmodern societies. Physicians are not trained to consider scurvy as a possible diagnosis in patients at risk; rather, it is considered a rare diagnosis to add to a differential for completeness's sake. Methods: We sought to describe the scorbutic patients seen by one physician during a busy academic emergency medicine career. Case series of patients seen by one physician between 1993 and 2023 at five academic teaching hospitals with Emergency Departments (EDs) in the mid-Eastern United States. Presenting signs and symptoms, known scurvy risk factors, Vitamin C levels, clinical course, and outcome for each patient are described. Results: There were 14 presentations by 12 patients diagnosed with scurvy who were initially evaluated in the ED between 1993 and 2023. Each patient had a known risk factor for inadequate Vitamin C intake. All had clinical findings suggestive of scurvy and all but one had a subnormal serum Vitamin C level detected on serum samples sent from the ED. Conclusion: The detection of 12 cases of scurvy by one physician over a three-decade period highlights the importance of screening for scurvy in at-risk populations and generates the hypothesis that scurvy is not a rare disease but rather a rare diagnosis. This research hypothesis should be investigated in further studies.

Development and validity evidence on the scale of perceived social support for university students (EPSSEU) during the period of social restrictions.

AIM: This study aims to validate a Perceived Social Support Scale for University Students (EPSSEU) during periods of social restrictions, by focusing on family and university support. SUBJECT AND METHODS: This cross-sectional study was conducted with undergraduate students from a public higher education institution. The college students who participated in the study-1353 at baseline and 378 after 6 months-answered a virtual questionnaire containing questions on: sociodemographic and lifestyle data, items proposed for the EPSSEU, Satisfaction with Social Support Scale (ESSS), and Depression, Anxiety and Stress Scale (DASS-21). Exploratory factor analysis, Cronbach's alpha reliability analysis, as well as discriminant, convergent, and known-group validations were performed. RESULTS: The results showed two factors support from: i) the university and ii) friends and family- which explained 61.82% of the variance in the data. The EPSSEU showed good reliability (Cronbach's alpha = 0.796) as well as validity, with higher scores among individuals without depression, anxiety, or stress. CONCLUSION: The EPSSEU shows adequate psychometric qualities and may be a useful instrument for assessing university students' social support in pandemics, social distancing, and remote teaching contexts.

Less restrictions in daily life: a clinical practice guideline for children with cancer.

PURPOSE: In current clinical practice, recommendations regarding restrictions in daily life for children with cancer are often lacking or not evidence-based. Critically reviewing the evidence and formulating recommendations are therefore of great importance as social restrictions (e.g., swimming, school attendance, sports) can impair the quality of life of these children severely. Therefore, our aim was to develop a clinical practice guideline for clinicians, children, and their parents regarding social restrictions in children with cancer. METHODS: A comprehensive multidisciplinary panel was assembled, comprising 21 professionals and patient representatives. A systematic literature review was performed, including dual appraisal of all citations. The GRADE methodology was used to extract, summarize, and assess the evidence. Multiple in-person meetings were held to rank outcomes, discuss evidence, complete evidence-to-decision frameworks, and formulate recommendations. Final recommendations were unanimously supported by all panel members. RESULTS: Six studies, including 758 children, formed the evidence base for the recommendations. Given the scarcity of the available evidence and various designs of studies in children with cancer, additional evidence was extracted from adult oncology guidelines, and shared expert opinions were utilized. In total, 14 recommendations were formulated of which multiple result in changes in current policy and standard of practice in the Netherlands. Topics covered in this guideline are swimming, having pets, visiting the zoo or farm, performing sports or high-velocity events, attending school or kindergarten, and use of public transport. This guideline is not intended to provide recommendations for patients after end of treatment, for palliative care settings, or for children undergoing a stem cell transplantation. CONCLUSIONS: In this clinical practice guideline, we provide recommendations regarding restrictions in daily life in children with cancer. These include evidence-based recommendations and, in the absence of sufficient evidence, recommendations based on expert evidence. With these recommendations, we provide guidance for clinicians, children, and parents and contribute to improving quality of life for children with cancer.

Incidence of induced abortion among commercially insured pregnant patients with cancer.

OBJECTIVES: This study aimed to characterize pregnancy outcomes and the incidence of induced abortion among pregnant people with a diagnosis of malignancy. STUDY DESIGN: We conducted a retrospective cohort study among privately insured people aged 12 to 55 years from the fourth quarter of 2015-2020 using US claims data from Merative MarketScan Research Databases. We included pregnancies from seven states with favorable policies for private insurance coverage of abortion. RESULTS: There were 1471 of 183,685 (0.8%) pregnancies with a cancer diagnosis. Among those receiving anticancer therapy, 21.6% (95% CI: 14.4-30.4%) underwent induced abortion compared with 10.9% (95% CI: 10.8-11.1%) of pregnant patients without a cancer diagnosis. CONCLUSIONS: Abortion restrictions may affect many pregnant women requiring cancer treatment in early pregnancy.

Local restrictions, population movement, and spillovers during the pandemic: Evidence from Japan's restaurant restriction.

We investigate how a local restaurant restriction aimed at containing the COVID-19 pandemic influenced population movement and COVID-19 prevalence within and outside the restricted districts. Using data on restaurant location and hourly population at the 500-m-mesh level and on COVID-19 prevalence at both prefecture and municipality level in Japan, we employ a triple-difference approach and a difference-in-differences approach with fixed effects. While the policy decreased population movement to restaurant areas in the restricted districts, it caused spillovers of increasing population movement to restaurant areas in the neighboring nonrestricted districts. Consequently, COVID-19 prevalence worsened in the neighboring nonrestricted districts but improved in the restricted districts. Our findings suggest that imposing such local restrictions in the context of the pandemic may contain the pandemic only in the restricted districts while sacrificing economic activities within these districts and public health in neighboring nonrestricted districts.

Variation in nutritional quality in UK retail eggs.

Fatty acid (FA), carotenoid and vitamin contents of UK eggs were assessed for four production systems (caged (CA), free-range (FR), organic (OR) and extensive organic (EO)) as well as season. The impact of enforced housing, due to avian influenza, was also investigated. Production system did not alter vitamin D3, B2 or B9 content, but significantly influenced nutritionally desirable FA, carotenoid and vitamins A and E - concentrations decreased as production intensity increased, although for most, CA and FR did not differ significantly. Vitamin E and FA profiles for OR and EO were also similar, although carotenoids were higher in EO eggs. In contrast, FA, carotenoids, vitamins E and B9 were consistent throughout the year, unlike vitamins A, D3 and B2, which fluctuated with season; D and B2 were higher in July than January and lower vitamin A was the only detected implication from enforced housing of FR and OR birds.

Impact of pandemic mobility restrictions on kidney transplant patients' experience: lessons on quality of care.

BACKGROUND: Patient perspectives on their post-operative health are acknowledged as valuable healthcare outcomes and should be scrupulously considered when designing interventions for patient-centered healthcare. Yet, following the COVID-19 lockdown and in the absence of standardized guidelines on how to best provide virtual chronic care to kidney transplant recipients, little is known about how this unique population coped and managed to comply with public health indications during confinement. METHODS: This study addresses this shortcoming by examining the experiences of patients from a tertiary hospital in Spain during the initial weeks of the lockdown decreed by the national government. Specifically, we focus our attention on the perceptions and experiences of these patients by retrieving robust qualitative and quantitative data: the former based on a thematic analysis of focus group transcripts, the latter obtained from a large-scale survey. RESULTS: Our findings identify opportunities for improvement in the quality of care and point to the provisions that might be made when facing future pandemics or lockdown-requiring situations. CONCLUSIONS: As healthcare services navigate evolving landscapes, our findings on the experience of kidney transplant recipients should enable hospital services to improve the quality of care they are able to provide to such patients during periods of restricted mobility, especially those associated with future disease emergencies, and considering that home confinement is often part of the natural course of post-operative care of these patients.