Effective Interventions Research Articles

Resistance to anti-smoking messages related to the higher smoking stigma of Korean female smokers

IntroductionThe degree of perceived smoking stigma can differ, based on various factors such as gender; this may influence the effect of smoking cessation interventions, including denormalization. This study investigates the gender differences in smoking stigma recognized by Korean smokers and explores the effect of these differences on the success of smoking cessation messages that aim to initiate an identity crisis among smokers. It aims to contribute to effective smoking cessation intervention strategies for female smokers.MethodsThe smoker-gender Implicit Association Test (IAT) was used to measure gender-based smoking stigma; the test comprised photos of people smoking, with positive and negative descriptors. Participants were 120 smokers aged 19–35 years (60 males and 60 females). Participants’ cognitive attitudes toward smoking and cessation intentions were assessed at baseline. To investigate the effect of social stigmatization on smokers, participants were asked to watch anti-smoking campaigns that stigmatized either smoking behavior or smokers’ self-identity. Cognitive attitudes and cessations intention were used to show differences in gender and message conditions.ResultsThe IAT D-score showed that female smokers perceived other female smokers significantly more negatively than they did male smokers, suggesting a higher level of smoking stigma. Female smokers in the socially stigmatizing condition reduced their negativity toward smoking less than those who were not stigmatized. Moreover, cessation intentions did not improve when female smokers received identity-threatening messages, indicating that female smokers tended to resist stigmatizing messages.DiscussionsThese findings provide empirical evidence that the gender of Korean smokers is significantly related to differences in smoking stigma. The negative perception and resistance responses of female smokers shown in this study are consistent with the findings of previous studies on the stigma of substance use disorders and addiction. High smoking stigma can also be a risk factor in anti-smoking interventions, including health communication; therefore, these findings should be interpreted with caution.

Effects of double neonatal stress on female rat sexual behaviour

Neonatal stress affects psychological and physiological development and may be associated with affective disorders. The aim was to examine the effects of double neonatal stress (DNS) – a combination of limited bedding and nesting (LBN) and repeated maternal separation (MS) – on the oestrous cycle and sexual behaviour of adult female rats. LBN was achieved by removing part of the wood shavings from the boxes. In the control group, each box was lined with 100 g of wood shavings, while in the experimental group there were only 10 g of wood shavings. MS was performed from P1 (P0 = day of birth) to P15. At P90, the sexual response of females in oestrus was evaluated. Statistical analysis was performed using two-way analysis of variance followed by Tukey's test. The size and profile of the oestrous cycle and the sexual behaviour of female rats submitted to the DNS were considered, as well as the influence of female behaviour on the sexual response of male rats. Female rats submitted to DNS showed a reduction in the lordosis quotient, suggesting a reduction in female receptivity. These rats also showed a reduction in the number of hops and darts, the number of ear wiggles, and the genital exploration time rate, suggesting a reduction in proceptivity. The males that interacted with the females of the DNS group showed a reduction in intromission ratio. Experimental model that mimics neonatal factors that affect adult female sexual response will allow more effective interventions to prevent and treat such changes. In addition, analysis of the female sexual response makes it possible to assess the general state of health and quality of life. In female rats, DNS exerted inhibitory effects on sexual behaviour. LBN was probably the most important factor. In conclusion, combating childhood poverty can be a key measure to prevent problems in the sex life of adults and improve overall health.

Peer Intervention to Link Overdose Survivors to Treatment (PILOT): Protocol for a Multisite, Randomized Controlled Trial Conducted Within the National Institute on Drug Abuse Clinical Trials Network.

The increase in opioid-related overdoses has caused a decrease in average life expectancy, highlighting the need for effective interventions to reduce overdose risk and prevent subsequent overdoses. Peer support specialists (PSSs) offer an appealing strategy to engage overdose survivors and reduce overdose risk, but randomized controlled trials are needed to formalize peer-led interventions and evaluate their effectiveness. This National Institute on Drug Abuse Clinical Trials Network (CTN) study is a multisite, prospective, pilot randomized (1:1) controlled trial (CTN protocol 0107) that aims to evaluate the effectiveness of an emergency department (ED)-initiated, peer-delivered intervention tailored for opioid overdose survivors (PeerIntervention to Link Overdose survivors toTreatment [PILOT]), compared with treatment as usual (TAU). This study evaluates the effectiveness of the 6-month, PSS-led PILOT intervention compared with TAU on the primary outcome of reducing overdose risk behavior 6 months after enrollment. Adults (aged ≥18 years; N=150) with a recent opioid-related overdose were identified and approached in the ED. Participants were screened and enrolled, either in the ED or within 7 days of ED discharge at research offices or in the community and then asked to complete study visits at months 1, 3, 6 (end of intervention), and 7 (follow-up). Participants were enrolled at 3 study sites in the United States: Greenville, South Carolina; Youngstown, Ohio; and Everett, Washington. Participants randomized to the PILOT intervention received a 6-month, PSS-led intervention tailored to each participant's goals to reduce their overdose risk behavior (eg, overdose harm reduction, housing, medical, and substance use treatment or recovery goals). Participants randomized to TAU received standard-of-care overdose materials, education, and services provided through the participating EDs. This paper describes the study protocol and procedures, explains the design and inclusion and exclusion decisions, and provides details of the peer-led PILOT intervention and supervision of PILOT PSSs. Study enrollment opened in December 2021 and was closed in July 2023. A total of 150 participants across 3 sites were enrolled in the study, meeting the proposed sample size for the trial. Primary and secondary analyses are underway and expected to be published in early 2025. There is an urgent need to better understand the characteristics of overdose survivors presenting to the ED and for rigorous trials evaluating the effectiveness of PSS-led interventions on engaging overdose survivors and reducing overdose risk. Results from this pilot randomized controlled trial will provide a description of the characteristics of overdose survivors presenting to the ED; outline the implementation of PSS services research in ED settings, including PSS implementation of PSS supervision and activity tracking; and inform ED-initiated PSS-led overdose risk reduction interventions and future research to better understand the implementation and efficacy of these interventions. ClinicalTrials.gov NCT05123027; https://clinicaltrials.gov/study/NCT05123027. DERR1-10.2196/60277.

Biocatalytic Clusterzyme Patches Restore Lung Function via Immunomodulation and Mitochondria Protection.

Currently, pulmonary complications such as lung infections during the perioperative period are still the main cause of prolonged hospitalization and death in patients with lung injury due to the lack of effective drugs. Clusterzyme, a kind of artificial enzyme with a high enzyme-like activity and safety profile, exhibits good effects on reducing oxidative stress and immunomodulation. Here, we present the functionalized patches that is administered on the lung airways and rescues the injured organ via clusterzymes. The long-term antioxidant capacity of the patches significantly ameliorated lipopolysaccharide-induced lung function impairment with a significant reduction in lung goblet cell metaplasia and oxidative stress. The inflammatory factors such as cytokines interleukin-1β, interleukin-6, and tumor necrosis factor-α levels decreased by 50%, while the mtDNA copy number increased by 50% and ATP production increased by 100%. Mice lung function was significantly improved, suggesting that the patches can rescue lung injury by modulating oxidative stress and immune responses as well as protecting the mitochondria, providing an avenue for effective intervention of lung injury.

Unhoused patients admitted to inpatient psychiatry at an academic, safety-net hospital: a cross-sectional study

ABSTRACT Introduction: There is a lack of data regarding unhoused patients admitted to inpatient psychiatry in the United States. The authors describe demographic and diagnostic features of unhoused patients admitted to an acute psychiatric inpatient unit (PIU) at an academic, safety net hospital. Methods: This is a cross-sectional, retrospective chart review of 57,902 adult patients admitted to the hospital between January 1, 2018 and May 31, 2023. Eleven percent (n = 6304) were admitted to the PIU and were part of further subgroup analysis examining housing status and primary behavioral health diagnoses. Chi-square tests of independence were used to determine associations between categorical variables. Results: The proportion of patients admitted to the PIU who were unhoused (33%, n = 2065) was 3 times greater than the proportion of patients admitted to non-psychiatric inpatient units who were unhoused (11%, n = 5450). On the PIU, unhoused patients compared to housed patients were more likely to be male (67 and 51%), have a psychotic disorder (35 and 19%) or a substance-related disorder (19 and 8%), and were less likely to have a mood disorder (22 and 44%). Conclusion: Understanding demographic and diagnostic factors is important to develop effective interventions to address the needs of unhoused patients on a PIU.

Predicting Adherence to Computer-Based Cognitive Training Programs Among Older Adults: Study of Domain Adaptation and Deep Learning.

Cognitive impairment and dementia pose a significant challenge to the aging population, impacting the well-being, quality of life, and autonomy of affected individuals. As the population ages, this will place enormous strain on health care and economic systems. While computerized cognitive training programs have demonstrated some promise in addressing cognitive decline, adherence to these interventions can be challenging. The objective of this study is to improve the accuracy of predicting adherence lapses to ultimately develop tailored adherence support systems to promote engagement with cognitive training among older adults. Data from 2 previously conducted cognitive training intervention studies were used to forecast adherence levels among older participants. Deep convolutional neural networks were used to leverage their feature learning capabilities and predict adherence patterns based on past behavior. Domain adaptation (DA) was used to address the challenge of limited training data for each participant, by using data from other participants with similar playing patterns. Time series data were converted into image format using Gramian angular fields, to facilitate clustering of participants during DA. To the best of our knowledge, this is the first effort to use DA techniques to predict older adults' daily adherence to cognitive training programs. Our results demonstrated the promise and potential of deep neural networks and DA for predicting adherence lapses. In all 3 studies, using 2 independent datasets, DA consistently produced the best accuracy values. Our findings highlight that deep learning and DA techniques can aid in the development of adherence support systems for computerized cognitive training, as well as for other interventions aimed at improving health, cognition, and well-being. These techniques can improve engagement and maximize the benefits of such interventions, ultimately enhancing the quality of life of individuals at risk for cognitive impairments. This research informs the development of more effective interventions, benefiting individuals and society by improving conditions associated with aging.

Driving Under the Influence of Alcohol and Cannabis by Sexual Identity, Race, Ethnicity, and Gender: A Nationwide Analysis Using the 2016 to 2019 National Survey on Drug Use and Health.

Sexual minority populations experience higher rates of substance use and related problems, but little is known about their specific involvement in driving under the influence (DUI) of alcohol (DUIA) and cannabis (DUIC) incidents. Using data from the 2016 to 2019 National Survey on Drug Use and Health, we used logistic regression models to estimate the interactive effects of sexual identity, race/ethnicity, and gender on past-year DUIA among adults who used alcohol and DUIC among adults who used cannabis, accounting for covariates. Using model estimates and linear combinations, we calculated the predicted probabilities of each outcome and compared sexual identity differences within and across race/ethnicity and gender. With few exceptions, the predicted probabilities of DUIA and DUIC were significantly higher among sexual minority women than heterosexual women of similar race/ethnicity. The results were more variable among men with the probabilities of DUIA and DUIC being significantly higher for some groups of sexual minority men and some groups having probabilities equal to or lower than similar heterosexual men. Some of the largest sexual minority gaps in DUIA and DUIC were observed among Hispanic and Other lesbian women and Black gay men. Sexual minority individuals are more likely to report DUI than their heterosexual counterparts; however, the risk of DUI among sexual minority populations varies by racial/ethnic and gender subgroup. Our findings indicate the importance of applying an intersectional framework when addressing substance-use-related disparities and when designing effective DUI prevention interventions for sexual minority populations.

Policy pathways to sustainable E-waste management: A global review

Electronic waste (E-waste) is a critical challenge of today's period, with around 57 million tons generated in 2021, of which only about 9 million tons were properly recycled, E-waste tends to affect the globe with issue like, illegal recycling, improper landfill disposal, illicit exports and others. Addressing this issue requires sustained, well-structured efforts, with effective policy interventions which are key towards reducing E-waste, by providing a framework for minimizing its generation and safeguarding the environment. These policies can ensure proper disposal methods, public awareness, device repair and refurbishment, and recycling rates with E-waste management monetizing the efforts of E-waste management startups. The study examines innovative E-waste policies across various countries which includes Extended Producer Responsibility (EPR), WEEE directives, regional laws, and State level laws, highlighting successful strategies such as incentivized recycling programs and stricter regulations on hazardous materials. The aim of the paper is to update information with an emphasis on global trends of E-waste, emphasizing the importance of robust policies in reducing environmental harm and lowering the cost of new electronics through efficient recycling.

Assessment of Functional outcomes Following Arthroscopy-Assisted Anterior Cruciate Ligament Reconstruction Utilizing Autograft Bone-Patellar Tendon-Bone

Anterior cruciate ligament (ACL) injuries are prevalent in athletes and active individuals, necessitating effective surgical interventions for restoring knee stability and function. This study evaluates the outcomes of Arthroscopic ACL reconstruction using bone-patellar tendon-bone (BPTB). This prospective study conducted from March 2022 to August 2023 evaluated the functional outcomes of 21 patients undergoing ACL reconstruction with BPTB autografts. Clinical assessments, including the Lachman and Lysholm scores, were utilized to assess knee stability and function preoperatively and postoperatively. Significant improvements were observed postoperatively in clinical assessments, with mean Lysholm scores increasing from 51.74 preoperatively to 91.64 at the 12-month follow-up (p < 0.001). The study also highlighted the prevalence of associated meniscal injuries and postoperative complications. Despite study limitations, including sample size constraints, our findings support the efficacy of ACL reconstruction with BPTB autografts in restoring knee function and stability. Evidence-based decision-making and comprehensive patient care are crucial for optimizing surgical outcomes in ACL injuries. Further research with larger cohorts and long-term follow-up is warranted to validate these results and explore optimal management strategies.

Testing the theory of normative social behavior in Italy and the USA during COVID-19

The COVID-19 pandemic has underscored the importance of understanding how social norms influence preventative health behaviors across cultures. Based on the theory of normative social behavior (TNSB), this study investigates the direct and moderated effects of social norms on intentions to wear masks and practice social distancing cross-culturally during the peak of COVID-19 in 2020. Representative samples were recruited from the United States (N = 333) and Italy (N = 331), two countries with different cultural tightness-looseness and orientations (individualistic-collectivistic; indulgence-restraint; uncertainty avoidance). Results revealed that perceived descriptive norms directly influenced behavioral intentions in the U.S., while perceived injunctive norms were more influential in Italy. Outcome expectations moderated the relationship between descriptive norms and mask-wearing intentions in both countries. Specifically, as perceived benefits increased, the effect of norms on mask-wearing intentions attenuated in both countries. Group identity strengthened the association between descriptive norms and mask-wearing intentions only in Italy. These findings highlight that cultural differences play an important role in normative influence mechanisms, with the U.S. being more influenced by what others do (descriptive norms) and Italy by what others approve of (injunctive norms). The study contributes to the refinement of the TNSB and emphasizes the importance of considering cultural factors in developing effective norm-based interventions to address global health challenges.

Adlerian Play Therapy and Dialectical Behavior Therapy Skills: An Integrated Approach

ABSTRACT The prevalence of youth mental illness in the United States is on the rise, and this increases the need for effective counseling interventions for children. This article introduces the integration of Adlerian play therapy (AdPT) and dialectical behavior therapy (DBT) skills with children who struggle with emotion dysregulation. We include an overview of both theoretical approaches, justification for integration, and a case study illustrating this dual approach in session. Finally, counseling implications and suggestions for future research are discussed.

Flaxseed oil attenuates PFOS-induced testicular damage by regulating RNA alternative splicing.

Background: Perfluorooctane sulfonate (PFOS) is a persistent, widely present environmental pollutant, and its toxicity to male reproduction has gradually attracted attention. Flaxseed oil (FO) is a dietary oil abundant in α-linolenic acid and has been demonstrated to possess multiple health benefits. However, whether FO protects against PFOS-induced testicular injury and its mechanism remain unclear. Methods: C57/BL6 mice were gavaged with different concentrations of FO or PFOS (10 mg kg-1) for 28 days. Blood and testicular tissues were collected for histopathology, proteomics, and biochemical and molecular analyses. Results: Our results showed that FO supplementation significantly attenuated PFOS-induced testicular injury, as indicated by histopathological changes, decreased oxidative stress level, increased sperm count, decreased rate of sperm malformation, and improved functional markers of spermatogenesis. Proteomic analysis showed that differentially expressed proteins were notably enriched in spliceosome pathways. Machine learning algorithms were used to screen the hub gene, and PRPF3 and PUF60 proteins were found to be important for FO to exert protective benefits to testicular injury. Western blot results confirmed that FO supplementation could increase the protein expression of PRPF3 and decrease the protein expression of PUF60 in PFOS-exposed mice. Conclusions: This study revealed that FO can alleviate PFOS-induced testicular dysfunction by regulating RNA alternative splicing. The spliceosome-related proteins PRPF3 and PUF60 may be the potential targets for FO to alleviate PFOS-induced testicular injury. FO supplementation may be an effective dietary intervention to prevent adverse effects of PFOS on testes.

Navigating the emotional maze: Understanding Adolescent suicidal ideation using CNN-LSTM model

Teenage suicidal ideation is on the rise, which emphasizes how crucial it is to recognize and comprehend the variables that contribute to this problem. Convolutional neural networks (CNNs), which are complex machine learning models capable of analysing intricate relationships within a network, are one possible strategy for addressing this issue. In our study, we employed a CNN-LSTM hybrid model to explore the complex relationships between teen suicide ideation and various risk variables, including depression, anxiety, and social support by analysing a substantial dataset of mental health surveys, seeking patterns and risk factors associated with suicidal thoughts. Our objective was clear: identify adolescents prone to suicidal ideation. With 24 parameters and a sample size of 3075 subjects, our model achieved an impressive F1-score of 97.8%. These findings provide valuable insights which helps in developing effective preventive interventions to address adolescent suicidal ideation, finding out the important patterns and risk variables related to suicidal thoughts. The study results offer important direction for developing preventive interventions that successfully address adolescent suicidal ideation.

The effect of eye mask on sleep quality and pain in patients undergoing coronary artery bypass graft surgery: A double-blind randomized controlled trial.

Pain is one of the common postoperative issues that impair recovery and quality of life in patients undergoing coronary artery bypass graft (CABG) surgery. It leads to prolonged recovery and sleep disturbances in patients. This study was conducted to examine the effect of eye mask use on sleep quality and pain in patients undergoing CABG surgery. A double-blind randomized trial design was employed. The study included 60 patients undergoing CABG surgery. They were divided into intervention and control groups through block randomization. Data were collected using a 'Demographic Characteristics Form', the 'Richards-Campbell Sleep Questionnaire (RCSQ)' and a 'Visual Analogue Scale' (VAS) through face-to-face interviews. While patients in the control group received standard care throughout the night, patients in the intervention group received standard care and used eye mask. All patients were followed up for three nights. The CONSORT was used to report the study. The main outcome of the study, the RCSQ score, was higher in the intervention group at baseline. The intervention group had higher RCSQ scores than the control group at time 1 and time 2. There were no differences between the groups in the secondary outcome, pain levels. The control group had higher pain scores at time 1 and time 2 than the intervention group. The use of an eye mask after CABG surgery is an effective, safe and simple nursing intervention to improve sleep quality and control pain. Because the use of an eye mask is an independent and unique nursing intervention, nurses should be supported and allowed to practise it.

Identification and biophysical characterization of potential phytochemical inhibitors of carboxyl/choline esterase from Helicoverpa armigera for advancing integrated pest management strategies

In the realm of disease vectors and agricultural pest management, insecticides play a crucial role in preserving global health and ensuring food security. The pervasive use, particularly of organophosphates (OPs), has given rise to a substantial challenge in the form of insecticide resistance. Carboxylesterases emerge as key contributors to OP resistance, owing to their ability to sequester or hydrolyze these chemicals. Consequently, carboxylesterase enzymes become attractive targets for the development of novel insecticides. Inhibiting these enzymes holds the potential to restore the efficacy of OPs against which resistance has developed. This study aimed to screen the FooDB library to identify potent inhibitory compounds targeting carboxylesterase, Ha006a from the agricultural pest Helicoverpa armigera. The ultimate objective is to develop effective interventions for pest control. The compounds with the highest scores underwent evaluation through docking studies and pharmacophore analysis. Among them, four phytochemicals—donepezil, protopine, 3′,4′,5,7-tetramethoxyflavone, and piperine—demonstrated favorable binding affinity. The Ha006a-ligand complexes were subsequently validated through molecular dynamics simulations. Biochemical analysis, encompassing determination of IC50 values, complemented by analysis of thermostability through Differential Scanning Calorimetry and interaction kinetics through Isothermal Titration Calorimetry was conducted. This study comprehensively characterizes Ha006a-ligand complexes through bioinformatics, biochemical, and biophysical methods. This investigation highlights 3′,4′,5,7-tetramethoxyflavone as the most effective inhibitor, suggesting its potential for synergistic testing with OPs. Consequently, these inhibitors offer a promising solution to OP resistance and address environmental concerns associated with excessive insecticide usage, enabling a significant reduction in their overuse.

Mortality associated with osteoporosis and pathological fractures in the United States (1999–2020): a multiple-cause-of-death study

BackgroundOsteoporosis with pathological fractures is a significant public health issue, contributing to morbidity, disability, diminished quality of life, and increased mortality. Understanding mortality trends related to this condition is crucial for developing effective interventions to reduce mortality and improve healthcare outcomes. This study aimed to analyze trends and causes of death associated with osteoporosis and pathological fractures in the United States using a multi-cause approach.MethodsAnnual death and age-standardized mortality rate (ASMR) data from 1999 to 2020 were obtained from the Centers for Disease Control and Prevention (CDC) mortality database. Death certificates listing ICD-10 M82 (osteoporosis with pathological fracture) as an underlying or related cause of death were analyzed. Epidemiological data were analyzed, and the ASMR data were calculated for each year, and trends were assessed using the Cochran-Armitage trend test.ResultsFrom 1999 to 2020, there were 40,441 deaths related to osteoporosis with pathological fractures in the United States, with a female-to-male ratio of 5.6:1. Among these, 12,820 deaths (31.7%) listed osteoporosis with pathological fractures as the underlying cause of death (UCD), yielding a female-to-male ASMR ratio of approximately 5.0-7.7:1. When classified as a non-UCD, the ASMR ratio was approximately 4.8–6.2:1. At the same time, we found that the total number of deaths classified as UCD and multiple causes of death (MCD), but the trend ratio of the two groups in different years did not change statistically significant (P > 0.05), and the ASMR of both groups showed a downward trend. The UCD-to-MCD ratio increased between 1999 and 2007, then decreased from 2007 to 2020. As MCD, the number of female deaths was more than that of male, and both showed a decreasing trend, but there was no statistical significance in the change of trend ratio in different years (P > 0.05). Deaths were predominantly concentrated in individuals over 75 years of age, with those over 84 years being the most affected. The number of deaths in different age groups showed a decreasing trend, and the change of trend ratio in different years was statistically significant (P < 0.05). White individuals had the highest number of deaths. The leading causes of death were heart diseases, chronic lower respiratory diseases, and alzheimer’s disease. In addition, the number of deaths of patients with prostate cancer and breast cancer showed a significant downward trend, and the change of trend ratio between the two groups in different years was statistically significant (P < 0.05).ConclusionsAlthough mortality from osteoporosis with pathological fractures is decreasing, anti-osteoporosis therapy remains essential for elderly patients. Healthcare providers should remain vigilant for potential complications, including malignant neoplasms, and ensure timely diagnosis and treatment to further reduce mortality in this population.

Primary cubital tunnel syndrome – surgical treatment methods and their effectiveness

Cubital tunnel syndrome (CuTS) is one of the most common neuropathies of the upper extremity. This condition, if left untreated, can significantly impact patients' everyday functioning and quality of life. Diagnosis of CuTS is mostly based on clinical evaluation but can be supplemented by electrodiagnostic studies, and various imaging techniques. Conservative treatments such as physical therapy, splinting, and anti-inflammatory medications are often first-line interventions. However, surgical approach may become necessary when conservative measures fail to provide relief or in cases of severe compression. There are numerous surgical approaches to treating CuTS and there is no clear consensus on one best method. Simple decompression of the ulnar nerve and its subcutaneous transposition are the most popular surgical techniques employed. Each method has its advantages and drawbacks, with varying implications for nerve recovery and postoperative complications. This review aims to provide a comprehensive overview of CuTS, while focusing on available surgical treatment approaches, their popularity and outcomes. Further research is warranted to refine surgical techniques and develop more effective interventions for this debilitating condition.

Implementation of collaborative care for depression in VA HIV clinics: Translating Initiatives for Depression into Effective Solutions (HITIDES): protocol for a cluster-randomized type 3 hybrid effectiveness-implementation trial

BackgroundDepression is the most diagnosed mental health condition among people living with HIV. Collaborative care is an effective intervention for depression, typically delivered in primary care settings. The HIV Translating Initiatives for Depression into Effective Solutions (HITIDES) clinical intervention involves a depression care team housed off-site that supports depression care delivery by HIV care providers. In a randomized controlled trial, HITIDES significantly improved depression symptoms for veterans living with HIV and delivered cost savings. However, no HIV clinics in the Veterans Health Administration (VHA) have implemented HITIDES; as such, it is unclear what implementation strategies are necessary to launch and sustain this intervention.MethodsThis hybrid type-3 effectiveness-implementation trial examines the implementation and effectiveness of HITIDES in 8 VHA HIV clinics randomly assigned to one of two implementation arms. Each arm uses a different implementation strategy package. Arm 1 includes an intervention operations guide; an on-site clinical champion who, with the help of a peer community of practice, will work with local clinicians and leadership to implement HITIDES at their site; and patient engagement in implementation tools. Arm 2 includes all strategies from Arm 1 with assistance from an external facilitator. The primary implementation outcomes is reach; secondary outcomes include adoption, implementation dose, depressive symptoms, and suicidal ideation. We will conduct a budget impact analysis of the implementation strategy packages. We hypothesize that Arm 2 will be associated with greater reach and adoption and that Arm 1 will be less costly.DiscussionPreliminary work identified implementation strategies acceptable to veterans living with HIV and HIV care providers; however, the effectiveness and cost of these strategies are unknown. While the depression care team can deliver services consistently with high quality, the ability of the depression care team to engage with HIV care providers at sites is unknown. Findings from this study will be used to inform selection of implementation strategies for a broad rollout to enhance depression and suicide care for people living with HIV.Trial registrationClinicalTrials.gov ID: NCT05901272, Registered 10 May 2023, https://clinicaltrials.gov/study/NCT05901272

대구 경북지역 병원종사자의 직무스트레스가 직무만족도에 미치는 영향에서 자아탄력성의 매개효과

Objectives The purpose of this study is to verify the mediating effect of ego resilience in the relationship between job stress and job satisfaction of hospital workers in the Daegu and Gyeongbuk regions. Methods An online survey was conducted targeting hospital workers working in the Daegu and Gyeongbuk regions from October 8, 2023 to October 15, 2023, and 86 copies were used in the final statistical analysis. The collected data were subjected to reliability analysis, frequency analysis, descriptive statistical analysis, multivariate normal distribution verification, correlation analysis, and regression analysis using SPSS V27.0, and the Sobel Test was performed to verify statistical significance. Results First, job stress of hospital workers in the Daegu and Gyeongbuk regions was found to have a significant negative effect on job satisfaction and ego resilience, and ego resilience was found to have a positive effect on job satisfaction. Second, ego resilience was found to mediate the relationship between job stress and job satisfaction among hospital workers in the Daegu and Gyeongbuk regions. Conclusions Through the results of this study, the relationship between job stress, job satisfaction, and ego resilience of hospital workers in the Daegu and Gyeongbuk regions was verified, and the relationship between major variables was confirmed theoretically and empirically, and key variables that affect hospital workers' job satisfaction were confirmed. It is meaningful in that it can provide basic data for early screening of hospital workers with low levels of job satisfaction and effective intervention by uncovering these factors. It is also significant in that it provided implications for the development of counseling and education programs related to job stress and ego resilience that can increase the job satisfaction of hospital workers in the Daegu and Gyeongbuk regions.

유연한 섭식절제가 섭식통제상실에 미치는 영향: 이분법적 사고와 반추의 매개효과(20대 여성을 대상으로)

Objectives This research attempts to subdivide controlled eating and binge eating behavior, and investigate the effects of flexible controlled eating on people’s psychological health. One also presents loss of control eating, a sub-variable of binge eating, as the independent variable to provide evidence on effective interventions when it comes to eating disorders. Methods 301 women in their twenties were surveyed online for data collection. SPSS 23.0 was used for descriptive statistics and correlation analysis, while MPLUS 7.4 was used to test structural modeling and mediation effects. Results First, all of the major variables were significantly positively correlated. Second, flexible control predicted loss of control eating both directly and indirectly. Third, dichotomous thinking did not mediate the relationship between flexible control and loss of control eating. Fourth, rumination mediated the relationship between flexible control and loss of control eating. Fifth, dichotomous thinking and rumination mediated the relationship between flexible control and loss of control eating in such order. Conclusions Such results show that high level of flexible control is associated with high level of dichotomous thinking and rumination, leading to increased loss of control eating. This indicates that women with high levels of flexible control can proceed through dichotomous thinking towards eating and rumination, subjecting them towards uncontrolled eating behaviors. One would conclude that control over eating according to external standards such as eating regulations, not internal hunger, may paradoxically lead to loss of control over eating.