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The firm grasp of the true inwardness of all things Indian is abundantly reflected in Kipling's writings, so much so that it has ever been said that they brought India [...], In this essay, I examine what I call the "gustatory coding" of Rudyard Kipling's Kim (1900-1901). I show how food in the novel delineates a sensory order of intelligence that can be known and mastered by a very specific kind of sahib: a white man with an Indian stomach. While so-called Mutiny foods, like cartridges, chapatis, flour, and salt had overwhelmed the imperial information order, Kim is overwhelmed by a love for such foods. The novel upholds a sensory knowledge of empire as necessary for an imperial heuristic. Thus Indian foodways in Kim operationalize imperial power and pleasure in ways where one does not preclude the other. Overall, I argue for gustatory coding as a reading method that can lead us to nuanced understandings of how imperial racial, linguistic, and sexual categories are narrativized. more...

Author(s): Isabela Landsteiner [1]; Jonathan A. Pinheiro [2]; Bruna Leles Vieira de Souza (corresponding author) [3]; Dione M. Setti Frizon [4]; Eduardo Federighi Baisi Chagas [5]; Spencer L. Marques Payão [...], The COVID-19 lockdown placed individuals at significant risk of social isolation. Particularly, older people were more vulnerable to the deleterious effects on mental and physical health caused by the COVID-19 pandemic quarantine, in which social confinement was associated with aggravated cognitive function among older adults. Correspondingly, it concerns the repercussions of the lockdown on the cognitive function of patients with dementia or Mild Cognitive Impairment (MCI) during the pandemic. This study aimed to assess the hypothesis that COVID-19 might cause cognitive decline in dementia patients due to social isolation by assessing changes in Mini-Mental State Examination (MMSE) scores between the pre and post-pandemic era. We systematically searched PubMed, Embase, and Cochrane Library for eligible studies from inception to April 2023. We included studies reporting the MMSE in patients with dementia or MCI one year prior to the beginning of the COVID-19 pandemic and one year after the lockdown. Standardized mean differences (SMD) with 95% confidence intervals (CI) were pooled with a random-effects model. Among 4,160 studies, twelve were included, comprising 4,096 patients with dementia or MCI. Patients with dementia exhibited significant MMSE decline compared to pre-pandemic levels (SMD = 0.341, P < 0.001). Similarly, MCI patients demonstrated an MMSE decline during lockdown (SMD = 0.315, P = 0.015). Sub-analyses of dementia types also indicated cognitive decline during lockdown, and a 12-month follow-up revealed an MMSE decline among dementia patients. During the COVID-19 lockdown, there was an overall decline in MMSE scores amongst those with dementia or MCI when compared to pre-pandemic parameters. Keywords: Coronavirus Disease-19, dementia, lockdown, mental status and dementia tests, mild cognitive impairment more...

Introduction Healthcare personnel are at risk for exposure to bloodborne pathogens, including HIV, hepatitis B, and hepatitis C. The greatest exposure risk is due to needlestick and sharps injuries that [...], Our study objectives were to describe injuries from sharps and gain insight into the culture of injury reporting among healthcare professionals at an academic medical center. We performed a retrospective chart review and analyzed sharps injuries reported in 2021 using chi-square analysis for categorical variables and t-tests or analysis of variance (ANOVA) tests for continuous variables. The highest rates of sharps injuries were reported by dental students (6.9%) and resident physicians (3.6%), followed by a smaller percentage of nurses, attending physicians, dental faculty, and medical students (p < .001). The majority of injuries were reported to occur while administering an injection and/or working in the dental clinics (39%). The median number of days to report an injury was 0 days for dental students, 2 days for resident physicians (p < .001), and 3 days for medical students (p = .004). We found that sharps injuries continue to occur in the clinical teaching environment and could reflect procedures that confer a higher risk of injury. Further, our study suggests that there is a stronger culture of reporting among dental students. Keywords: needlestick, sharps injuries, reporting culture, dental students, academic medical center more...

Human social contact patterns drive the transmission of pathogens that spread through proximity. Data on social contact patterns are critical to understand who contacts whom and infer who acquires infection [...] more...

In the early stages of epidemics caused by emerging pathogens transmitted through respiratory or close-contact routes, social distancing has been a key strategy for mitigating transmission (1-3). Given the substantial [...] more...

Incels, a portmanteau of 'involuntary' and 'celibate,' are men who self-identify as being celibate against their wishes and experience significant distress related to their lack of sexual and romantic connections [...], The incel population comprises men experiencing involuntary celibacy who mingle based on their challenges in establishing romantic connections. Despite the current issues plaguing incel forums (e.g., violent content), they were originally conceived as platforms for social support to alleviate loneliness among sexually inexperienced individuals. However, documentation of support types within these forums is limited. The aim of this study was to document the exchange of social support within incel forums, utilizing Braithwaite et al.'s (1999) adaptation of Cutrona and Suhr's (1992) social support typology (informational, emotional, esteem, network, tangible support) to analyze the forms of support exchanged within incels forums. Thematic analyses of 37 threads from r/IncelExit (i.e., users seeking to leave inceldom) and Incels.is (i.e., users deeply entrenched in inceldom) reveal a prevalence of informational support, followed by emotional support. These findings align with existing literature positing that informational support is the prevailing type in online interactions on forums between strangers, where anonymity also facilitates the intimate exchanges characteristic of emotional support. Notable distinctions emerge between the two forums: r/IncelExit favoured informational support (prioritized when the problem is perceived as controllable) to suggest concrete actions to resolve the problem, while Incels.is emphasized emotional support (prioritized when the problem is perceived as uncontrollable) to show empathy and understanding of the situation. Our findings also reveal that antisocial support (i.e., encouraging self-destructive behaviours instead of providing genuine support) was sometimes present, especially on Incels.is. This study provides an initial exploration of support dynamics in incels forums, with implications for interventions. KEYWORDS: Incels, involuntary celibacy, online forum, psychosexual development, qualitative analysis, quantitative methods, social support more...

As of 2024, approximately 4% of the North American population identifies as part of the 2S/LGBTQIA+ (1) community, a term used to 'encompass many different sexualities, sexes and genders, including [...], Although 20% of couples who seek medically assisted reproduction (MAR) identify as 2S/LGBTQIA+, MAR services are primarily based on a medical/cisgender definition of infertility, failing to account for 2S/LGBTQIA+ individuals' experience of social infertility--that is, their inability to conceive due to their relationship status. Whereas the consequences of the MAR process on various aspects of mixed-gender/sex couples have been demonstrated (e.g., emotional, relationship, sexuality, social life), the generalization of this knowledge to the 2S/LGBTQIA+ community remains unexplored. This qualitative study aimed to explore the specific impacts of MAR on different aspects of 58 Canadian 2S/LGBTQIA+ couples' lives. While participants were asked about the impact of their MAR journey on the various spheres of their lives, the thematic analysis revealed that what proved most central to their experience were the barriers they encountered to access sensitive and inclusive care, echoing themes from existing literature such as heteronormativity and cisnormativity, a lack of tailored services, psychological distress triggered by the MAR process, and experiences of stigma and discrimination. Other themes outside the healthcare context were also identified: financial burden, a lack of social models and support systems, the emotional toll of repeatedly coming out, and microaggressions from family members. These findings underscore the urgent need for targeted research and reforms in reproductive healthcare to better serve 2S/LGBTQIA+ couples and address the systemic barriers they face. KEYWORDS: Medically assisted reproduction, 2S/LGBTQIA+, sexual orientation more...

Adolescence has long been understood as a developmental period marked by rapid physical, cognitive, and social change, including the ongoing construction and refinement of a coherent sense of personal identity [...], Gender and sexual identity development (GSID) are formative tasks of adolescence and young adulthood. For LGBTQ2S+ individuals, these processes may be complicated by issues of safety, support, and access to resources. A potential avenue for identity experimentation is tabletop role-playing games (TRPGs), cooperative narrative games wherein players adopt fictional personas and describe their actions within a fantasy setting arbitrated by a facilitator. Previous studies provide indications of the significance of TRPGs to GSID but have generally been limited to small sample sizes and/or specific demographic subgroups that lack a specific inclusion of LGBTQ2S+ youth within their samples. The current study sought to address these gaps and investigate the role of TRPGs to GSID among LGBTQ2S+ individuals during adolescence and young adulthood by generating and analyzing a digital ethnography composed of anonymous online public posts (N = 211) across four social media platforms authored by current self-identified LGBTQ2S+ youth and young adults, or self-identified LGBTQ2S+ adults retroactively reflecting on their youth and/or young adulthood (N = 199). Thematic analysis revealed a range of themes highlighting the significance of TRPGs to GSID organized under five overarching categories: (a) Identity Expression, Exploration, and Experimentation through Role-Play; (b) Navigating Safety and Visibility; (c) Enactment and Embodiment of Possibility through Fantasy; (d) Agency, Power, and Resistance; and (e) Personal Significance and Impact to Life and Well-Being. KEYWORDS: Gender and sexual identity, identity development, LGBTQ2S+, play and leisure, tabletop role-playing games more...

Humor is how we love each other. My mama always told me to marry a man who makes me laugh. -Participant Quotation Observation of popular magazines and websites shows that [...], Research shows that humour is related to relationship satisfaction, but little is known about couples' use of sexual humour. The current study examined sexual humour use and its associations with relational humour, relationship satisfaction, and sexual satisfaction. Participants (adults in a romantic relationship of at least 4 months; N = 196) completed online measures of the frequency, nature, and perceptions of sexual humour use, relational humour use, relationship satisfaction, and sexual satisfaction, and they described an example of sexual humour their partner had used. Participants indicated that sexual humour was used at least occasionally with their partner. Examples of sexual humour suggest several common forms (e.g., inside jokes/rituals, physical humour, smoothing over awkward moments). Most participants perceived positive consequences of sexual humour, including increased comfort, fun, and closeness. More frequent use of positive relational humour (by self and partner) was associated with more frequent and more positively valenced sexual humour, whereas more frequent negative relational humour use by partner predicted lower relationship and sexual satisfaction. Finally, more positively valenced sexual humour predicted sexual satisfaction over and above relationship satisfaction and relational humour. Relationship and sexual humour are related to both relationship and sexual satisfaction. Sexual humour may help mitigate discomfort with potentially awkward situations and facilitate individual comfort as well as connection with a partner. The unique contribution of sexual humour to sexual satisfaction suggests it may play a modest but distinctive role in sexual well-being. Implications and future directions are discussed. KEYWORDS: Humour, relationship satisfaction, romantic relationships, sexual humour, sexual satisfaction more...

The frequency of sexual activity among young adults has shown significant declines in recent years (Herbenick et al., 2022), with some suggestions that these declines are due to competing interests [...], Sexual activity can provide important opportunities for fulfilling experiences that contribute to greater relationship satisfaction and overall well-being, yet young adults are reporting fewer partnered sexual interactions. According to self-determination theory, when people perceive their needs for autonomy, competence, and relatedness are met in relationships, they report greater relationship and sexual well-being, whereas need frustration contributes to relationship dysfunction and dissatisfaction. In the current cross-sectional study, we extend these ideas to a sexual context. We hypothesized that sex-specific need satisfaction would be associated with higher sexual desire, sexual satisfaction and relationship satisfaction and lower sexual distress beyond that of general need satisfaction within one's relationship. We expected opposite associations for sex-specific need frustration. Partnered individuals aged 18-29 (N = 197) completed online measures of sexual and relationship need satisfaction and frustration, sexual desire, sexual and relationship satisfaction, and sexual distress. Controlling for need satisfaction within the relationship, which was associated with higher desire and satisfaction, multivariate regression analyses indicated that sex-specific need satisfaction was associated with higher sexual desire, higher sexual and relationship satisfaction, and lower sexual distress. Furthermore, sex- specific need frustration was associated with higher sexual distress. While need satisfaction in one's relationship and sex life may have benefits for sexual desire and sexual and relationship satisfaction, promoting need satisfaction and minimizing need frustration specific to sex may be helpful in minimizing sexual distress. Implications for researchers and clinicians highlight the importance of distinguishing between psychological need satisfaction (and frustration) across different relational contexts. KEYWORDS: Relationship well-being, sex-specific need fulfillment, sexual distress, sexual satisfaction, sexual well- being more...

INTRODUCTION Malnutrition, specifically undernutrition, is a prevalent issue among children under the age of 5 and poses a significant health concern that impacts child development in numerous countries globally. The [...], The Indonesian Nutrition Status Study stated that cases of underweight or malnutrition with a weight for age index are around 17%. The efforts made by the government today to overcome the problem of malnutrition of children under five in Indonesia are still not optimal with programs that have been made by the government. The incidence of underweight continues to increase from 2019 to 2022 in Indonesia. The development of a culture-based intervention &apos;Papadangan&apos; which is a communal eating activity was carried out to reduce this number. This study was conducted to develop the &apos;Papadangan&apos; culture so that it becomes one of the efforts that can be done by the government. This eating habit can be used as an alternative for the community to increase the appetite of children under five in Tangerang, meaning that indirectly the community has made efforts to improve nutrition in children under five through eating together in the area. This research used Participatory Action Research (PAR) which consists of 2 cycles. This research was conducted from November 2022 to January 2024. Fifty participants consisting of children and caregivers were involved in this study. The Children under five weights were measured before and after the procedure using assessment instruments, the z score table, the camstock feeding scale and the toddler anthropometric table. Indepth interviews were conducted with mothers of children under five to explore the eating habits of Sundanese children under five with underweight and good nutritional status. &apos;Papadangan&apos; can be developed into a strategy to prevent underweight nutrition problems by adding nutrition and health education: paying attention to the feeding schedule of children under five years old, variations in food consumption, education related to elements of balanced nutrition, and eating hygiene in the implementation of papadangan eating culture activities. &apos;Papadangan&apos; can be used as one of the strategies to reduce the incidence of underweight in children under five years old. Developing the papadangan eating culture has become a new research, and this strategy is effective in changing the eating patterns of toddlers and reducing the rate of malnutrition among toddlers in Pekayon village, Sukadiri District, Tangerang City. Key words: Eating culture, children under five years old, malnutrition, qualitative, Indonesia more...

INTRODUCTION Local conditions in South Sudan during the 10-plus years that have elapsed since its independence on July 9, 2011, have led to the deaths of hundreds of thousands of [...], South Sudan is the newest country in the world - it has been experiencing recurrent conflict and climatic shocks such as flooding and hunger, creating a protracted humanitarian situation where 9 million people - three-quarters of South Sudan's population--are projected to require humanitarian and protection assistance in 2024. Two million people remain displaced due to decades of conflict, intercommunal violence and extreme effects and events of climate change, such as flooding and dry spells (OCHA 2024). Lack of coherent early warning identifiers and adequate monitoring mechanisms exacerbate acute shocks and chronic stresses due to both manmade and natural calamities amongst vulnerable communities in Ulang County. This paper aims at ascertaining the existing mechanisms and indicators that the community utilize for monitoring and early warning of habitual natural and man-made disasters. This study used both quantitative and qualitative data collection techniques. Quantitative data were gathered through a household survey using a structured questionnaire from 120 displaced households had been affected by floods and episodes of inter-communal violence. The household survey used two-stage cluster sampling with probability proportionate to size (PPS) to identify respondents. The qualitative data were collected through focus group discussions with men and women representatives located along the Sobat river. Key informant interviews with local leaders at County, Payam and Boma level were equally conducted to gather comprehensive information, and gain a better understanding of the context and draw sound recommendations and conclusions. Descriptive and comparative methods were used in the bid to grasp the prevailing early warning identifiers and the monitoring systems or mechanisms in place for repeated flooding, inter-communal violence and revenge killings. The research findings uncovered that 55.8% of respondents are aware of both traditional early warning indicators to climate-related shocks as well as to inter-communal violence. Community Managed Disaster Risk Reduction (CMDRR) committees have been established to bolster preparation against disasters and facilitate early response. The CMDRR structure has enabled timely preparedness and provides leadership for any response or post-disaster activities prior to receiving assistance from humanitarian actors. On the other hand, inadequate monitoring systems and tools amongst the duty bearers and limited capacity of the County leadership and other public institutions both at State and County level make the monitoring and early warning of recurrent disasters less effective. Furthermore, funding constraints remains one of the major challenges cited by humanitarian actors that often curtails their efforts in collaborating with government counterparts in tackling disaster risks in a more sustainable manner. Key words: Resilience, monitoring, early warning, disaster, Ulang county, South Sudan more...

The onset of the COVID-19 pandemic resulted in substantial restrictions to medical care delivery, including the provision of surgical oncology care. (1-3) In Ontario, which has a population of about [...], Background: At the beginning of the COVID-19 pandemic, access to "planned" surgical care was restricted as the health care system responded to the coronavirus. We hypothesized that the pandemic resulted in diagnostic and therapeutic delays, leading to stage migration among patients with malignancies treated with a Whipple procedure. Methods: This study is a retrospective review of adults who underwent surgical exploration for a planned pancreaticoduodenectomy for malignancy at St. Joseph&apos;s Health Centre between March 11, 2019, and March 11, 2021. Results: We included 180 patients in the study. Baseline characteristics, pathologic diagnoses, and perioperative outcomes were similar between the 2 cohorts. The post-COVID group had longer median wait times from date of consent (p < 0.001), and from computed tomography (CT) scan (p < 0.001), to surgery. There were increased rates of R1 margin positivity in the post-COVID group (p = 0.01). We saw an association between higher wait times from consent and the last CT scan to the date of operation, and increased rates of R1 margin positivity in the first year of the pandemic. Conclusion: This study demonstrated the importance of prioritizing care during a pandemic and provided evidence for potential long-term consequences when there are delays in surgery for aggressive gastrointestinal malignancies. Contexte : Au d but de la pand mie de COVID-19, l&apos;acc s aux soins chirurgicaux << planifi s >> a t limit alors que la r action au coronavirus accaparait le syst me de sant . Nous avons mis l&apos;hypoth se que la pand mie a entra n des retards diagnostiques et th rapeutiques, conduisant une migration des stades chez les patientes et patients atteints de cancer qui ont subi une op ration de Whipple (pancr atoduod nectomie). M thodes : Cette tude est une revue r trospective portant sur les adultes qui ont subi une exploration chirurgicale en vue d&apos;une pancr atoduod nectomie planifi e pour un cancer au St. Joseph&apos;s Health Centre entre le 11 mars 2019 et le 11 mars 2021. R sultats : Nous avons inclus 180 patientes et patients dans notre tude. Les caract ristiques de d part, les diagnostics pathologiques et les r sultats p riop ratoires taient similaires dans les 2 cohortes. Le groupe post-COVID a connu des temps d&apos;attente m dians plus longs de la date du consentement (p < 0,001) et de la tomodensitom trie (TDM) (p < 0,001) la date de l&apos;intervention. Le taux de positivit de la marge R1 tait plus lev dans le groupe post-COVID (p = 0,01). Nous avons observ une association entre des temps d&apos;attente plus longs de la date de consentement et de la derni re TDM la date de l&apos;intervention, et une hausse du taux de positivit de la marge R1 au cours de la premi re ann e de la pand mie. Conclusion : Cette tude d montre l&apos;importance de donner la priorit aux soins pendant une pand mie et fournit des donn es probantes sur les cons quences potentielles long terme des retards en chirurgie pour les tumeurs gastro-intestinales agressives. more...

THE ALMOST complete lack of reflection on the normalization of assisted reproductive technologies for producing children is a telling sign of the unseriousness of our age. The transformation of our [...] more...

Well-being For students, well-being is an essential component of their college experience. Subjective well-being refers to how an individual evaluates their life both affectively and cognitively, particularly with life satisfaction, [...], College students face many challenges when adjusting to classes, making friends, and potentially living away from home for the first time. Collegiate athletes face even further challenges due to the amount of time and energy dedicated to their sport. Protective factors that can allow students to thrive under pressure and protect well-being include mental toughness and social connectedness. Using both quantitative and qualitative methods, the present study examined the influence of mental toughness and social connectedness on wellbeing in undergraduates and how this differs based on levels of sport participation and physical activity. Data were collected from 163 participants from a Northeastern U.S. university, including Division I athletes, club athletes, intramural players, students who worked out, and students who were physically inactive. Higher levels of mental toughness and social connectedness were significant predictors of well-being at all activity levels. In addition, those who were physically active scored significantly higher in mental toughness and social connectedness compared to those who were physically inactive. Open ended responses provided further evidence that staying physically active, particularly with participation in sports, provided a sense of belonging that related to positive well-being and an enhanced college experience. This study demonstrates the importance of physical activity in enhancing well-being of college students through numerous positive protective factors. Keywords: Physical activity, athletes, mental toughness, social connectedness, well-being more...

Clad in a cobalt blue jumpsuit--the field outfit of the Pasteur Institute of Madagascar (IPM)--Malagasy scientist Adelaide Miarinjara was tweezing fleas, one by one, from a plate of soapy water, [...] more...

Author(s): Karnam Anand [1]; Sai Sirisha [2]; Sanjana Putta [3]; Sudhindra Vooturi [1]; Manas Panigrahi [4]; Sita Jayalakshmi [1]; Subhash Kaul (corresponding author) [1] Introduction Decompressive craniectomy (DC) is known [...], Background and Objectives: For stroke survivors (SS) who undergo decompressive craniectomy (DC), quality of life is intertwined with the care they receive. Burden on caregiver becomes an important determinant of recovery of SS. In this study, we aimed to analyze the determinants of burden on caregivers of SS who undergo DC. Methods: Caregivers of 198 SS who underwent DC formed the study population of this prospective observational study. The study was conducted in a tertiary referral unit between September 2019 and March 2021. Caregiver burden was quantified using Zarit Burden Interview. Analysis for association between the reported burden and modified Rankin Scale (mRS) score was done. Results: Mean age of the participants was 47.00 ± 11.2 years. The mRS outcome was poor in SS aged >60 years, Glasgow coma scale (GCS) score at presentation of Conclusion: Early DC and care at rehabilitation unit were associated with better functional outcomes in SS. Nearly 75% of caregivers of patients post-DC reported high burden of providing care to SS, and the burden increased linearly with mRS score. Keywords: Stroke, caregiver burden, decompressive craniectomy, quality of life more...

INTRODUCTION On October 7, 2023, Israeli citizens experienced profound shock and trauma. Over 1,200 Israelis, including Jews, Christians, and Muslims of all ages, from infants to the very elderly, were [...], Family medicine is well-established in Israel and serves as the foundation of the Israeli health care system. On October 7, 2023, Israel experienced a profound shock and trauma when over 1,200 Israelis, including Jews, Christians, and Muslims of all ages, were brutally murdered, tortured, raped, burned alive, or taken hostage by Hamas terrorists from Gaza. This essay provides a contextual view from the vantage point of an Israeli family physician. It touches on the horror of the conflict while proposing that family physicians can stand as beacons of hope, offering healing and solace to all in need. more...

Primary care is the backbone of many health care systems around the world. (1) With 15 years of experience in primary care, 6 of those as a family physician, and [...], Providing care for families under occupation has always been marked by scarce resources and too many patients. The current war in Gaza has dramatically worsened conditions in the Occupied Territories of Palestine (OTP). A family physician and her team in the southern West Bank describe their own challenges and give voice to the physicians in the OTP they interviewed to better understand the professional and personal challenges of living and working during the uncertainty of war. more...

War appears to be an unfortunate fact of life for populations across the globe throughout recorded history. At this moment, major wars are occurring in Ukraine, Sudan, and the Middle [...], Wars and conflicts appear to be a fact of life for populations across the globe, often in places where family medicine functions as the backbone of the health care system. In these situations, family physicians are frequently called on to serve in expanded roles and are witnesses to the enormous mental and physical suffering of individuals, families, communities, and populations. This article examines the lessons family medicine can learn from current wars and other terrible conflagrations. more...

INTRODUCTION The October 7, 2023 terrorist attack in Israel profoundly affected the nation, triggering reflections on resilience, trauma, and societal response as communities grappled with the aftermath. With countless individuals [...], This study investigates the well-being, resilience, and burnout of health care personnel treating evacuees with severe trauma following a major terrorist attack in southern Israel on October 7, 2023. Longitudinal trends and factors influencing personnel&apos;s emotional states are explored. Questionnaires from 129 health care personnel recruited from primary care clinics, including those serving evacuees exclusively, revealed significant correlations of self-efficacy and well-being with gender and religiosity, impacting burnout levels. Professional experience and exposure to traumatized evacuees were also linked to well-being. This research addresses a crucial gap in understanding personnel&apos;s emotional resilience and guiding interventions to enhance personnel well-being and improve patient care quality. more...

INTRODUCTION It is widely accepted that health-related social needs (HRSN), such as food, housing, and transportation, play a critical role in overall health and wellbeing. (1,2) The COVID-19 pandemic amplified [...], PURPOSE Efforts during the COVID-19 pandemic to address the health-related social needs (HRSN) of Medicare and Medicaid beneficiaries, such as food and housing, were insufficient. We examined HRSN data from the Accountable Health Communities study collected in Oregon to understand changes in these needs at the onset and during the first 2 years of the pandemic. METHODS We conducted an interrupted time series analysis with data from 21,522 Medicare and Medicaid beneficiaries screened for overall HRSN between May 13, 2019 and December 24, 2021. Secondary interrupted time series analyses were conducted for each type of HRSN assessed with the Accountable Health Communities screening tool: food, housing, transportation, utilities, and interpersonal safety. RESULTS The interrupted time series analysis indicated an abrupt 17.7-percentage point increase in overall HRSN around March 23, 2020, which did not significantly decline during the subsequent 2 years. Food, housing, and interpersonal safety needs increased by 16.5, 15.9, and 4.4 percentage points, respectively, with no significant decline thereafter. Transportation and utility needs increased by 7.2 and 7.5 percentage points, respectively, but decreased significantly after the start of the pandemic (decreasing by 0.2 and 0.1 percentage points each week, respectively). CONCLUSIONS The jump in HRSN following the start of the pandemic and the persistence of need, particularly in food and housing, highlight the importance of research to better understand which public health and health care interventions, investments, and policies effectively address HRSN. more...

Introduction Road traffic injuries among motorcyclists and cyclists are a public health concern. In 2019, road traffic crashes killed 237 533 motorcyclists and 66 102 cyclists worldwide. (1) In the [...], Objective To examine changes in red-light running and distracted riding among motorcyclists and cyclists before and after the 2020 implementation of the One Helmet, One Seatbelt campaign in China. Methods We obtained 192 hours of film before (2019) and after (2021) implementation of the campaign in eight road intersections in Changsha. We calculated percentages and ratios of red-light running and distracted riding. To assess the associations between these traffic behaviours and the campaign, we used multivariable logistic regression models to calculate adjusted odds ratios (aOR). Findings We filmed 5256 motorcyclists and cyclists in 2019 and 6269 in 2021. Red-light running decreased from 45.1% to 41.5% during this period (ratio: 0.92; 95% confidence interval, CI: 0.88-0.96), while distracted riding increased from 3.5% to 5.0% (ratio: 1.42; 95% CI: 1.19-1.69). After adjusting for covariates, male riders were more likely to run a red light compared to female riders (aOR: 1.28; 95% CI: 1.06-1.55). Red-light running was also more likely among electric bicycle riders (aOR: 1.46; 95% CI: 1.10-1.95) and motorcyclists (aOR: 1.47; 95% CI: 1.13-1.90) compared to traditional cyclists. All types of riders were less prone to run a red light during peak hours than off-peak hours (aOR: 0.85; 95% CI: 0.73-0.99). Distracted riding was more common on weekends compared to weekdays (aOR: 3.01; 95% CI: 2.02-4.49). Conclusion China&apos;s national road safety campaign, which focuses on helmet and seatbelt use, was associated with reduced red-light running. Strict enforcement and targeted modifications could improve the campaign&apos;s effectiveness. Objectif Etudier les changements en matiere de franchissement des feux rouges et de distraction chez les motocyclistes et cyclistes avant et apres la mise en reuvre, en 2020, de la campagne <> (Un casque, une ceinture) en Chine. Methodes Nous nous sommes procure 192 heures de video filmees a huit carrefours routiers a Changsha avant (2019) et apres (2021) la mise en reuvre de la campagne. Nous avons ensuite calcule les pourcentages et ratios de franchissement des feux rouges et de cyclistes ou motocyclistes distraits. Pour determiner le lien entre ces comportements de conduite et la campagne, nous avons employe des modeles de regression logistique multivariee nous permettant de calculer les odds ratios ajustes (ORA). Resultats En 2019, 5256 motocyclistes et cyclistes ont ete filmes, contre 6269 en 2021. Le franchissement des feux rouges a diminue, passant de 45,1% a 41,5% durant cette periode (ratio: 0,92; intervalle de confiance de 95%, IC: 0,88-0,96), tandis que la distraction a augmente, passant de 3,5% a 5,0% (ratio: 1,42; IC de 95%: 1,19-1,69). Apres avoir pris en compte les covariables, les conducteurs etaient davantage susceptibles de franchir un feu rouge que les conductrices (ORA: 1,28; IC de 95%: 1,06-1,55). Ce franchissement etait egalement plus frequent chez les velos electriques (ORA: 1,46; IC de 95%: 1,10-1,95) et les motocyclistes (ORA: 1,47; IC de 95%: 1,13-1,90) que chez les cyclistes traditionnels. Tous les types de deux-roues etaient moins enclins a franchir un feu rouge pendant les heures de pointe que pendant les heures creuses (ORA: 0,85; IC de 95%: 0,73-0,99). Enfin, les cyclistes ou motocyclistes distraits etaient plus nombreux le week-end que la semaine (ORA: 3,01; IC de 95%: 2,02-4,49). Conclusion La campagne nationale de securite routiere en Chine, axee sur le port du casque et de la ceinture de securite, a entraine une baisse du nombre de franchissements des feux rouges. Une application stricte des regles ainsi que des modifications ciblees pourraient ameliorer l&apos;efficacite de cette campagne. Objetivo Examinar los cambios en la conduccion distraida y el cruce de semaforos en rojo entre motociclistas y ciclistas antes y despues de la implementacion en 2020 de la campana <> en China. Metodos Se obtuvieron 192 horas de grabacion antes (2019) y despues (2021) de la implementacion de la campana en ocho intersecciones viales de Changsha. Se calcularon los porcentajes y las razones de saltarse semaforos en rojo y de conduccion distraida. Para evaluar las asociaciones entre estos comportamientos de trafico y la campana, se utilizaron modelos de regresion logistica multivariable para calcular las razones de probabilidades ajustadas (aOR). Resultados Se filmaron 5256 motociclistas y ciclistas en 2019 y 6269 en 2021. Saltarse los semaforos en rojo disminuyo del 45,1% al 41,5% durante este periodo (razon: 0,92; intervalo de confianza del 95%, IC: 0,88-0,96), mientras que la conduccion distraida aumento del 3,5% al 5,0% (razon: 1,42; IC del 95%: 1,19-1,69). Tras ajustar por covariables, los conductores varones tenian mas probabilidades de saltarse un semaforo en rojo que las conductoras (aOR: 1,28; IC del 95%: 1,06-1,55). Ademas, los conductores de bicicletas electricas (aOR: 1,46; IC del 95%: 1,10-1,95) y motociclistas (aOR: 1,47; IC del 95%: 1,13-1,90) eran mas propensos a saltarse semaforos en rojo que los ciclistas tradicionales. Todos los tipos de conductores eran menos propensos a saltarse un semaforo en rojo durante las horas de maxima afluencia que fuera de ellas (aOR: 0,85; IC del 95%: 0,73-0,99). La conduccion distraida fue mas frecuente los fines de semana que entre semana (aOR: 3,01; IC del 95%: 2,02-4,49). Conclusion La campana nacional de seguridad vial de China, centrada en el uso del casco y el cinturon de seguridad, se asocio a una reduccion de los conductores que se saltan los semaforos en rojo. Una aplicacion estricta y modificaciones especificas podrian mejorar la eficiencia de la campana. more...

Introduction Planning and organizing mass gatherings pose public health challenges for organizers, health authorities and governments. (1,2) In 2020, the emergence and spread of severe acute respiratory syndrome coronavirus 2 [...], Evidence about the impact of mass gatherings during the coronavirus disease 2019 (COVID-19) pandemic on the number of disease cases and on the health-care systems of host countries is limited. Additionally, there have been few publications on the lessons identified from the adaptation of mass gatherings held during the pandemic, including the implementation of comprehensive public health and social measures aimed at reducing viral transmission. This article describes preparations made for the 2020 Union of European Football Associations (UEFA) European Football Championship (UEFA Euro 2020) by the World Health Organization&apos;s (WHO) Regional Office for Europe, UEFA and other stakeholders after the championship had been rescheduled because of the COVID-19 pandemic. Technical guidance on preparations for the football tournament and risk assessment tools were provided by WHO. A task force established by the WHO Regional Office for Europe conducted traditional and event-based disease surveillance before and during UEFA Euro 2020, monitored public health and social measures in the 11 host countries, and developed a risk communication and community engagement strategy that involved multimedia campaigns targeting news and social media, fans, athletes, event organizers and other stakeholders. The lessons and good practices identified during UEFA Euro 2020 are described to help guide preparations for future mass gatherings in health emergencies. Sharing data and recommendations on best practice from previous mass gatherings with the organizers and countries involved in planning for a major event is particularly important. Peu de preuves existent concernant l&apos;impact des rassemblements de masse lors de la pandemie de maladie a coronavirus 2019 (COVID-19) sur le nombre de cas et sur les systemes de soins de sante des pays hotes. En outre, rares sont les publications consacrees aux enseignements qui ont decoule de l&apos;adaptation des rassemblements de masse organises durant la pandemie, notamment la mise en reuvre de mesures sociales et sanitaires globales visant a limiter la transmission du virus. Le present article decrit les preparatifs effectues dans le cadre du championnat d&apos;Europe de football 2020 (UEFA Euro 2020) de l&apos;Union europeenne des associations de football (UEFA) par le Bureau regional de l&apos;Organisation mondiale de la Sante (OMS) pour l&apos;Europe, l&apos;UEFA et d&apos;autres parties prenantes apres le report de la competition en raison de la pandemie de COVID-19. Des directives techniques relatives a ces preparatifs ainsi que des outils d&apos;evaluation des risques ont ete fournis par l&apos;OMS. Un groupe de travail cree par le Bureau regional de l&apos;OMS pour l&apos;Europe a mene une surveillance epidemiologique et evenementielle avant et pendant l&apos;UEFA Euro 2020, analyse les mesures sociales et sanitaires dans les 11 pays hotes et developpe une strategie de communication des risques et d&apos;engagement communautaire impliquant les medias et reseaux sociaux, les supporters, les athletes, les organisateurs d&apos;evenements et d&apos;autres intervenants. Les lecons tirees et les bonnes pratiques identifies au cours de l&apos;UEFA Euro 2020 sont detaillees ici afin d&apos;aider a encadrer les preparatifs de futurs rassemblements de masse dans des situations d&apos;urgence sanitaire. Partager les donnees et recommandations sur les meilleures pratiques observees lors de precedents rassemblements de masse avec les organisateurs et pays prenant part a la planification d&apos;un evenement de grande envergure est essentiel. Los datos sobre el impacto de las concentraciones masivas durante la pandemia de la enfermedad por coronavirus de 2019 (COVID-19) en el numero de casos de la enfermedad y en los sistemas sanitarios de los paises anfitriones son limitados. Ademas, ha habido pocas publicaciones sobre las lecciones identificadas a partir de la adaptacion de las concentraciones masivas celebradas durante la pandemia, incluida la aplicacion de medidas sanitarias y sociales integrales destinadas a reducir la transmision viral. Este articulo describe los preparativos que la Oficina Regional para Europa de la Organizacion Mundial de la Salud (OMS), la UEFA y otras partes interesadas realizaron para el Campeonato Europeo de Futbol 2020 de la Union de Asociaciones Europeas de Futbol (UEFA) (Eurocopa 2020 de la UEFA) tras la reprogramacion del campeonato a causa de la pandemia de la COVID-19. La OMS proporciono orientacion tecnica sobre los preparativos del torneo de futbol y herramientas de evaluacion de riesgos. Un grupo de trabajo creado por la Oficina Regional para Europa de la OMS se encargo de la vigilancia de enfermedades tradicional y basada en eventos antes y durante la Eurocopa 2020 de la UEFA, superviso las medidas sociales y de salud publica en los 11 paises anfitriones y elaboro una estrategia de comunicacion de riesgos y participacion de la comunidad que incluia campanas multimedia dirigidas a los medios de comunicacion y las redes sociales, los aficionados, los atletas, los organizadores de eventos y otras partes interesadas. Se describen las lecciones y buenas practicas identificadas durante la Eurocopa 2020 de la UEFA para ayudar a orientar los preparativos de futuras concentraciones masivas en emergencias sanitarias. Es fundamental compartir los datos y las recomendaciones sobre las mejores practicas de anteriores concentraciones masivas con los organizadores y los paises implicados en la planificacion de un evento de gran envergadura. more...

Introduction Family is a vital organ in the establishment and maintenance of societies as it facilitates relations and aims for compatibility among individuals in the community and is where children [...], This study aimed to investigate the attitudes of university students in the United Arab Emirates towards the marriage of people with disabilities. To achieve this goal, a sample of 396 students, consisting of 222 women and 174 men, was selected. All participants were administered a scale of 15 items built according to the closed-ended Likert. The results indicated a high level of positive attitudes towards this type of marriage. Furthermore, the results showed no statistically significant differences in attitudes attributed to variables such as gender and academic year, while there were statistically significant differences favoring students in scientific colleges over those in humanities colleges regarding academic specialization. The study also reflects a wider gendered analysis based on the field of Arab women with disabilities studies. This might help us to understand how the cultural and societal nature of these norms could impact ways in which students view marriage amongst people with disabilities thus providing more insights into an intersection between gender and disability within UAE. The study concluded with several recommendations, including that the UAE law on the rights of persons with disabilities must emphasize the right to marriage for persons with disabilities. Keywords: Marriage of people with disabilities, University students, Gender variable, Academic specialization more...

Individuals with serious mental illness are over 10 times as likely to experience use of force in interactions with law enforcement than those without serious mental illness. (1) Furthermore, approximately [...] more...

Introduction Violence against women is a global health problem rooted in gender inequality. (1) Preventing violence against women in Indonesia is a distinct challenge: despite the existence of laws and [...], Problem Violence against women is a global health problem. Effectively preventing such violence requires locally adapted strategies. Approach The World Health Organization in Indonesia, in collaboration with United Nations (UN) Population Fund, UN Women, United Nations Children&apos;s Fund, United Nations Development Programme and Joint United Nations Programme on HIV/AIDS, launched capacity-building initiatives to introduce RESPECT as an evidence-based framework to address violence against women. The initiatives included stakeholder engagement, module development, sensitization training, a workshop and evaluation sessions. These sessions introduced RESPECT strategies to government officials, UN officers and community representatives, mapped best practices and developed action plans. Local setting Indonesia has a substantial burden of violence against women, despite numerous laws and policies to combat it. The 2021 Indonesian violence against women survey showed that 26.1% (3341/12 800) of women aged 15-64 years had experienced violence in their lifetime, with 8.7% (1114/12 800) experiencing violence in the past year. Relevant changes The initiatives to introduce RESPECT led to securing government support, and verbal commitment was given by the Director for the Protection of Women&apos;s Rights against Domestic Violence and Vulnerability to integrate RESPECT into the 2025-2029 National Development Plan and National Strategy for Reducing Violence Against Women. Lessons learnt RESPECT can be adapted to local contexts through customization and capacity-building and by ensuring initial government support, dedicated personnel, resource allocation and use of established relationships with key stakeholders. Improved research, monitoring and evaluation are vital to promote evidence-informed decision-making, together with community engagement and multistakeholder collaboration. The UN can facilitate these efforts. [phrase omitted] Probleme La violence a l&apos;egard des femmes est un probleme de sante mondial. Lutter efficacement contre de telles violences necessite des strategies adaptees aux differents contextes locaux. Approche En collaboration avec le Fonds des Nations unies pour la population (FNUAP), l&apos;ONU Femmes, le Fonds des Nations unies pour l&apos;enfance, le Programme des Nations unies pour le developpement et le Programme commun des Nations Unies sur le VIH/sida, l&apos;Organisation mondiale de la Sante en Indonesie a lance une serie d&apos;initiatives de renforcement des capacites afin d&apos;instaurer RESPECT, un cadre methodologique fonde sur des faits dont le but est de lutter contre les violences envers les femmes. Parmi ces initiatives figuraient l&apos;implication des parties prenantes, le developpement de modules, une formation a la sensibilisation, un atelier et des sessions d&apos;evaluation. Ces sessions ont servi a presenter les strategies RESPECT a des responsables du gouvernement, des fonctionnaires de l&apos;ONU et des representants des communautes, a identifier les meilleures pratiques et a elaborer des plans d&apos;action. Environnement local Malgre de nombreuses lois et politiques visant a lutter contre la violence envers les femmes, elle demeure un veritable fleau en Indonesie. Une enquete menee en 2021 dans le pays a montre que 26,1% (3341/12 800) des femmes agees de 15 a 64 ans avaient subi des violences au cours de leur vie, et que 8,7% (1114/12 800) y avaient ete confrontees au cours de l&apos;annee ecoulee. Changements significatifs Les initiatives visant a mettre en place RESPECT ont permis d&apos;assurer le soutien du gouvernement, tandis que le directeur charge de la protection des droits des femmes contre les violences domestiques et les facteurs de vulnerabilite s&apos;est engage verbalement a integrer RESPECT dans le Plan national de developpement et la Strategie nationale de reduction de la violence a l&apos;egard des femmes 2025-2029. Lecons tirees Le cadre methodologique RESPECT peut etre adapte aux differents contextes locaux par le biais de la personnalisation et du renforcement des capacites, mais aussi en veillant a obtenir l&apos;appui initial du gouvernement, en disposant d&apos;un personnel specialise, en attribuant des ressources et en utilisant les relations etablies avec les principales parties prenantes. Lamelioration de la recherche, du suivi et de l&apos;evaluation est cruciale pour promouvoir des processus decisionnels etayes par des faits, tout comme l&apos;implication des communautes et la collaboration multilaterale. LONU peut contribuer a ces efforts. [phrase omitted] Situacion La violencia contra las mujeres es un problema sanitario mundial. Para prevenirla de manera eficaz se necesitan estrategias adaptadas a las circunstancias locales. Enfoque La Organizacion Mundial de la Salud en Indonesia, en colaboracion con el Fondo de Poblacion de las Naciones Unidas (ONU), ONU Mujeres, el Fondo de las Naciones Unidas para la Infancia, el Programa de las Naciones Unidas para el Desarrollo y el Programa Conjunto de las Naciones Unidas sobre el VIH/SIDA, emprendio iniciativas de capacitacion para introducir RESPECT como marco basado en evidencias para abordar la violencia contra las mujeres. Las iniciativas incluyeron la participacion de las partes interesadas, el desarrollo de modulos, formacion de sensibilizacion, un taller y sesiones de evaluacion. En estas sesiones se presentaron las estrategias de RESPECT a funcionarios del gobierno, oficiales de las Naciones Unidas y representantes de la comunidad, se trazaron las mejores practicas y se desarrollaron planes de accion. Marco regional Indonesia tiene una carga considerable de violencia contra las mujeres, a pesar de las numerosas leyes y politicas para contrarrestarla. La encuesta sobre violencia contra las mujeres realizada en Indonesia en 2021 mostro que el 26,1% (3341/12 800) de las mujeres de entre 15 y 64 anos habian sufrido violencia a lo largo de su vida, y el 8,7% (1114/12 800) en el ultimo ano. Cambios importantes Las iniciativas para introducir RESPECT llevaron a conseguir el apoyo del gobierno. Ademas, el Director para la Proteccion de los derechos de la mujer contra la violencia domestica y la vulnerabilidad se comprometio verbalmente a integrar RESPECT en el Plan nacional de desarrollo 2025-2029 y en la Estrategia nacional para reducir la violencia contra la mujer. Lecciones aprendidas Se puede adaptar RESPECT a los contextos locales mediante la personalizacion y el desarrollo de capacidades, y garantizando el apoyo inicial del gobierno, la dedicacion de personal, la asignacion de recursos y el uso de las relaciones establecidas con las principales partes interesadas. La mejora de la investigacion, el seguimiento y la evaluacion son vitales para promover la toma de decisiones basada en evidencias, junto con la participacion de la comunidad y la colaboracion de multiples partes interesadas. La ONU puede facilitar estos esfuerzos. more...