Gender-Affirming Psychotherapy (GAP): Core Principles and Skills to Reduce the Mental Health Care "GAP" for Transgender Youths.

Objective: Transgender youths are more likely than cisgender youths to need mental health care because of their high exposure to discrimination and victimization, including within health care systems. Accordingly, transgender youths have low care satisfaction and high rates of treatment dropout, further exacerbating existing mental health inequities. To reduce these inequities, mental health providers need knowledge and skills to enhance transgender youths' treatment engagement and benefits.

The Glass Ceiling in Global Health: Perspectives of Female and Male Anesthesiologists.

Background: Gender equity is essential for improving health outcomes globally. Despite comprising 75% of the global health workforce and dominating academic global health programs, women remain underrepresented in leadership positions in global health organizations. Our study aimed to identify potential gender differences in the beliefs and attitudes regarding barriers that women anesthesiologists encounter in pursuing careers and leadership roles in global health and to identify recommendations for improving gender equity in global health.

The dual orexin receptor antagonist suvorexant in alcohol use disorder and comorbid insomnia: A case report.

Key Clinical Message: This case suggests using dual orexin receptor antagonists to treat alcohol use disorder and comorbid sleep disorders may be effective, commencing treatment in withdrawal and continuing it to prevent relapse.

Abstract: Effective medications for the treatment of alcohol use disorder are limited. This is partially due to the heterogenous nature of the symptomatology associated with alcohol use disorder and the abundance of presenting comorbidities.

National action plans on antimicrobial resistance in Latin America: an analysis via a governance framework.

In 2015, the World Health Assembly adopted a global action plan (GAP) on antimicrobial resistance (AMR). Member states were encouraged to develop their own national action plans (NAPs) in alignment with the GAP. To-date, in systematic assessments of NAPs, the Latin American specific context has not been previously analysed.

General Practitioner Educators on Clinical Debrief: A Qualitative Investigation into the Experience of Teaching Third-Year Medical Students to Care.

There is a paucity of research reporting the experiences of general practitioner clinical educators. Providing education for students could lead to better clinical skills and greater job satisfaction for the educator. However, it could also result in increased stress and mental fatigue, adding to what is an already pressured situation in the current primary care climate.

Sex bias in utero alters ovarian reserve but not uterine capacity in female offspring†.

Environmental stressors to which a fetus is exposed affect a range of physiological functions in postnatal offspring. We aimed to determine the in utero effect of steroid hormones on the reproductive potential of female offspring using a porcine model. Reproductive tracts of pigs from female-biased (>65% female, n = 15), non-biased (45-54.

A flexible tool for the assessment of the economic cost of pig disease in growers and finishers at farm level.

Pigmeat is the most consumed red meat globally and consumption is expected to continue to increase. The sector is faced by the risk of epidemic and endemic disease impacts and other adverse influences. The aim of this study was to develop a dynamic simulation model of pig growing and finishing that can be used to model the financial and economic impacts of a variety of scenarios both related to disease effects and other influences on production.

A Placebo-Controlled Randomized Trial of Vigabatrin in the Management of Acute Alcohol Withdrawal.

Objective: To undertake a double blinded randomised placebo-controlled trial to assess the efficacy of vigabatrin, a GABA-transaminase inhibitor, as a benzodiazepine sparing agent in the management of acute alcohol withdrawal syndrome in a residential setting.

Methods: We enrolled 120 patients with alcohol use disorder who were randomly assigned to either treatment with vigabatrin (2g/day for 4 days) or placebo. The primary outcome was defined as the number of participants in each treatment arm needing diazepam for withdrawal management.

Population dynamics of free-roaming dogs in two European regions and implications for population control.

Changes in free-roaming dog population size are important indicators of the effectiveness of dog population management. Assessing the effectiveness of different management methods also requires estimating the processes that change population size, such as the rates of recruitment into and removal from a population. This is one of the first studies to quantify the size, rates of recruitment and removal, and health and welfare status of free-roaming dog populations in Europe.

Transformations to regenerative food systems-An outline of the FixOurFood project.

This paper provides an outline of a new interdisciplinary project called FixOurFood, funded through UKRI's 'Transforming UK food systems' programme. FixOurFood aims to transform the Yorkshire food system to a regenerative food system and will work to answer two main questions: (1) What do regenerative food systems look like? (2) How can transformations be enabled so that we can achieve a regenerative food system? To answer these questions, FixOurFood will work with diverse stakeholders to change the Yorkshire food system and use the learning to inform change efforts in other parts of the UK and beyond. Our work will focus on shifting trajectories towards regenerative dynamics in three inter-related systems of: healthy eating for young children, hybrid food economies and regenerative farming.

Targeted policy intervention for reducing red meat consumption: conflicts and trade-offs.

Background: There are a range of policies and guidelines focused on meat consumption which aim to tackle health and environmental issues. Policies are often siloed in nature and propose universal limits on consumption. Despite this, there will be a number of conflicts and trade-offs between interest groups.

Assessing the impact of free-roaming dog population management through systems modelling.

Free-roaming dogs can present significant challenges to public health, wildlife conservation, and livestock production. Free-roaming dogs may also experience poor health and welfare. Dog population management is widely conducted to mitigate these issues.

Judgment Bias During Gestation in Domestic Pigs.

In humans and rats, changes in affect are known to occur during pregnancy, however it is unknown how gestation may influence mood in other non-human mammals. This study assessed changes in pigs' judgment bias as a measure of affective state throughout gestation. Pigs were trained to complete a spatial judgment bias task with reference to positive and negative locations.

Reducing opioid prescribing on discharge after orthopedic surgery: Does a guideline improve opioid prescribing practice?

Aim: To investigate adherence to discharge advice in a prescription opioid prescribing guideline (GL) post-orthopedic surgery.

Methods: The guideline in draft form was introduced in February 2018. To assess longer-term adherence to discharge advice and to understand which components of that advice were adhered to, regular audits of discharge prescribing were performed after formal GL launch in February 2019, a year after the draft of the GL had been available.

Attitudes towards free-roaming dogs and dog ownership practices in Bulgaria, Italy, and Ukraine.

Free-roaming dog population management is conducted to mitigate risks to public health, livestock losses, wildlife conservation, and dog health and welfare. This study aimed to determine attitudes towards free-roaming dogs and their management and describe dog ownership practices in three European countries. We distributed an online questionnaire comprising questions relating to dog ownership practices and attitudes towards free-roaming dogs using social media.

Reducing opioid prescribing on discharge after orthopaedic surgery: does a guideline and education improve prescribing practice 1 year later?

Background: An intervention Prescription Opioid Practice Improvement (POPI), addressing opioid prescribing on discharge following orthopaedic surgery, demonstrated improved practice. Here we report the sustainability of improved practice at 12 months, and the impact of a booster education intervention, POPI SOS (Safe Opioid Supply).

Methods: Audits were performed using methodology described in previously published studies.

Behavioural and Physiological Correlates of the Canine Frustration Questionnaire.

Frustration is a negative emotional state implicated in a range of canine behaviour problems. The Canine Frustration Questionnaire (CFQ) is the first psychometric tool developed to assess frustration tendencies in dogs based on owner report. However, to date, no published studies have assessed behavioural and physiological correlates of this trait.

Pharmacokinetics, Safety, and Tolerability of a Medicinal Cannabis Formulation in Patients with Chronic Non-cancer Pain on Long-Term High Dose Opioid Analgesia: A Pilot Study.

Introduction: This phase I open-label study examined pharmacokinetics, safety, and tolerability of escalating doses of a novel combination cannabinoid medication (1:1 tetrahydrocannabinol [THC]/cannabidiol [CBD]) in patients with chronic non-cancer pain (CNCP) on high dose opioid analgesia.

Methods: Nine people with CNCP and oral morphine equivalent daily dose of 60 mg or higher were recruited. Blood concentrations of THC, 11-hydroxytetrahydrocannabinol (OH-THC), 11-nor-9-carboxy-tetrahydrocannabinol (COOH-THC), and CBD were assayed weekly.

Systematic review and meta-analysis of opioid use at 3, 6 and 12 months post-operatively by opioid naïve orthopaedic surgery patients.

Background And Objective: There is evidence that opioid initiation post-surgery is contributing to the problem of chronic misuse and/or abuse of over the counter medications in the community, and that orthopedic patients may be particularly at risk. The aim of the systematic review with meta-analysis was to identify research that examined opioid use at 3, 6, and 12 months post-operatively by previously opioid naïve orthopedic surgery patients. Design, databases, and data treatment: A searched review with meta-analysis was undertaken.

Geodemographic Patterns of Meat Expenditure in Great Britain.

The future of the meat industry will require the management of important trade-offs between economic, environmental and health aspects of both humans and animals. Understanding the patterns and trends of meat expenditure and consumption is crucial for assessing the current resilience of the system and for economic, planning, health and environmental applications. Here, we show how the technique of geodemographic classification, combined with fine scale expenditure estimates can be used to explore temporal and spatial patterns of meat expenditure in Great Britain between 2008 and 2017.

From principles to practice: embedding clinical reasoning as a longitudinal curriculum theme in a medical school programme.

There is consensus that clinical reasoning (CR) is crucial for increasing the value of diagnosis, medical decision-making and error reduction. These skills should be developed throughout medical education, starting with undergraduate study. International guidance provides principles for CR curricula but interventions to date, are short term in nature.

The 5-HT receptor as a therapeutic target for alcohol and methamphetamine use disorders: A pilot study in treatment-seeking individuals.

Alcohol use disorder (AUD) and methamphetamine use disorder (MUD) are prevalent and have high adverse impacts on both the individual and society. Current treatment strategies for these disorders are ineffective at a population level. Lorcaserin, a 5-HT receptor agonist, has shown potential at reducing the symptoms of substance use disorder.

Is Magnesium Supplementation an Effective Nutritional Method to Reduce Stress in Domestic Pigs? A Systematic Review.

In commercial pig production, stressful events are common and can have detrimental impacts on the pig's health and welfare, as well as on the performance of the farm. Supplementary magnesium may reduce stress, and subsequent harmful and aggressive behaviors, that occur during stressful events, such as regrouping. However, reports on the efficacy of this treatment are mixed.

Provincial Door-to-Needle Improvement Initiative Results in Improved Patient Outcomes Across an Entire Population.

Background And Purpose: Improving door-to-needle times (DNTs) for thrombolysis of acute ischemic stroke patients improves outcomes, but participation in DNT improvement initiatives has been mostly limited to larger, academic medical centers with an existing interest in stroke quality improvement. It is not known whether quality improvement initiatives can improve DNT at a population level, including smaller community hospitals. This study aims to determine the effect of a provincial improvement collaborative intervention on improvement of DNT and patient outcomes.