The occupational experiences of lesbian, gay, bisexual and transgender (LGBT) individuals during the coming out process: An analysis of self-acceptance, disclosure, and occupational change

Human occupation is an intensely individual process that is colored by the cultural and life experiences of the individual who is engaged in an activity. The experiences of gender and sexual minorities typically defined as Lesbian, Gay, Bisexual, and Transgender (LGBT) individuals are different in many ways from the rest of the population. One occupation unique to this community is the process of “coming out” in which the individual discloses their minority sexual orientation or gender identity to others. The coming out process is complex and multi-faceted, involving both the internal reflective process of first self-accepting one’s orientation and identity and then the process of sharing it with others. Because of the stigmatized nature of LGBT orientations and identities this occupation often precipitates a great deal of occupational change involving occupational deprivation, marginalization, adaptation and gain

From John Yudkin to Jamie Oliver : a short but sweet history on the war against sugar

In 2016, an anti-sugar campaign headed by celebrity chef Jamie Oliver was launched in the United Kingdom. Dubbed a ‘crusade against sugar’, Oliver’s documentary Sugar Rush examined Britain’s penchant for sweetness, exposing the health implications of excessive consumption and calling on the British government to tax sugary drinks in order to reduce obesity and diet-related diseases. In the midst of the furore that ensued, the National Obesity Forum (NOF) and the Public Health Collaboration (PHC) published a report, which demanded a major overhaul of official dietary guidelines. The report condemned the dietary doctrine of ‘low fat’, which had dominated official dietary guidelines in the United Kingdom since 1983, alleging the advice was based on ‘flawed science’ which had failed to curb rates of obesity and type 2 diabetes. Their call intensified the debate even further; while members of the PHC described low-fat guidelines as ‘the biggest mistake in modern medical history’, others warned that reversing the current guidelines may prove disastrous for public health

Five Week Summer School Program Improved Glucose and Lipoprotein Profiles in Hispanic Female High School Students

There has been a drastic rise in obese children and adolescents in the past few decades. Evidence suggests that adolescents decrease physical activity during the summer months, contributing to this rise. Purpose: To investigate whether a 5-week summer school program involving physical activity has an effect on plasma glucose levels and lipid profiles among Hispanic female high school students. Methods: Thirty-three female high school students (15-17 years) from an underprivileged Hispanic area in southern Texas were randomly assigned to either an experimental group that participated in a summer school program (n=17) or a control group that did not participate (n=16). All participants had a body mass index (BMI) greater than the 85th percentile. The summer school program was held 5 days per week (08:00-16:00) for 5 weeks, involving a variety of physical activities (aerobic exercise, muscular strength and endurance training, sports games, and fun activities such as tag and ball games etc.) for 90 minutes each day. Non-summer school attendants maintained normal summer activity. Overnight-fasting blood (5 mL) was collected pre- and post-study to analyze changes in plasma glucose and lipid profiles. All data were analyzed by a two-way analysis of variance (ANOVA) with the Sidak’s post-hoc test for any significant interactions. When LDL-C and glucose variables were different between baseline groups, the delta analysis was conducted (p \u3c 0.05). Results: Regardless of summer school attendance, HDL-C was reduced by 1.77 mg/dL (42.75±0.63 mg/dL to 40.98±0.63 mg/dL), which was statistically significant (p=.033). After participation in the summer school program, LDL-C and glucose levels decreased by 12.44±5.16 mg/dL and 5.55±3.83 mg/dL, respectively, as opposed to the levels of these parameters in non-participants which increased by 4.10±5.51 mg/dL and 8.13±5.09 mg/dL, respectively. No other variables were significantly different. Conclusion: LDL-C and plasma glucose levels were reduced significantly in participants in the summer school program as compared to those of non-summer school participants. Although HDL-C decreased independently of the summer school program, it remained within a healthy range. Therefore, the summer school program may be an effective method of improving plasma glucose and lipid profiles

A Cross-Sectional Study of Symptom Prevalence, Frequency, Severity, and Impact of Long-COVID in Scotland: Part I

Background: Commonly reported symptoms of long COVID may have different patterns of prevalence and presentation across different countries. While some limited data have been reported for the United Kingdom, national specificity for Scotland is less clear. We present a cross-sectional survey to examine the symptom prevalence, frequency, and severity of long COVID for people living with the condition in Scotland. Methods: An online survey was created in the English language and was available between April 21, 2022 and August 5, 2022. Participants were included if they were ≥18 years old, living in Scotland, and had self-diagnosed or confirmed long COVID; and excluded if they were hospitalized during their initial infection. Within this article we quantify symptom prevalence, frequency, severity, and duration. Results: Participants (n = 253) reported the most prevalent long-COVID symptoms to be post-exertional malaise (95%), fatigue/tiredness (85%), and cognitive impairment (68%). Fatigue/tiredness, problems with activities of daily living (ADL), and general pain were most frequently occurring, while sleep difficulties, problems with ADL, and nausea were the most severe. Scottish Index of Multiple Deprivation associated with symptom number, severity, and frequency, whereas vaccine status, age, sex, and smoking status had limited or no association. Conclusions: These findings outline the challenges faced for those living with long COVID and highlight the need for longitudinal research to ascertain a better understanding of the condition and its longer-term societal impact

A Cross-Sectional Study of Symptom Prevalence, Frequency, Severity, and Impact of Long COVID in Scotland: Part II

Background: There has been some effort to map the prevalence, frequency, and severity of symptoms of long COVID at local and national levels. However, what is frequently absent from such accounts is details of the impact the disease and its symptoms have had on those living with the condition. In this article, we present details of the impact on work, caring, and mental health gathered using a cross-sectional survey. Methods: Data were collected using an online survey that was available from April 21, 2022, to August 5, 2022. Included participants had either self-diagnosed or confirmed long COVID, were living in Scotland, and were aged ≥18 years. Hospitalization during initial COVID-19 infection was an exclusion criterion. Participants were asked to report on the impact of their illness on everyday activities such as working, studying, or caring. They also completed an assessment of their current mood. Results: People with long COVID were often severely impacted in their ability to work and study. Severe impact on work and study were predicted by more severe and more frequent fatigue, more severe pain, and more severe cognitive impairment. Respondents’ ability to care for child dependents was also associated with more severe and more frequent fatigue, and more severe cognitive impairments. More severe pain associated with greater impact on adult care. Negative mood correlated most strongly with frequency and severity of neurological symptoms, including lack of attention, loss of smell, impaired sense of smell, loss of taste, impaired sense of taste, and loss of appetite. Conclusions: Long COVID has a significant impact on ability to work, study, and care for dependents. The severity of this impact is associated with specific symptom burden, including fatigue, pain, and cognitive impairment

“You think you’re going to get better”:a creative-relational inquiry into Long Covid and physical activity

This creative-relational inquiry explores the lived experience of people suffering from Long Covid. Responding to calls for a publicly oriented qualitative inquiry, we collaborate across an extended project team to develop and share an accessible and engaging performance text which advocates for and supports those who live precariously as a result of contracting Long Covid. We offer our performance text as a resource to inform and guide personal, professional, public, and policy responses to Long Covid. We propose that creative-relational inquiries such as this beneficially extend understanding beyond what is possible through traditional evidence-based medicine alone

Case Report: Don’t chew the fufu: a case report of suspected drug body stuffing

Background: Intrabody concealment of illicit substances is a common practice in the trafficking chain. Body packing is a technique used in drug trafficking that consists of deliberately ingesting many drug pellets. Body stuffing consists of precipitously swallowing packets of substances, which are smaller and more fragile than body-packing pellets, for concealment from law-enforcement officers in anticipation of impending search or arrest. Therefore, body stuffing is particularly dangerous due to the rupture risk of the loosely wrapped drug packets, which could lead to substance intoxication or even death. Case presentation:  This article reports the case of a young man who was taken by law enforcement authorities to our Emergency Department for investigation of suspected body stuffing. Although the patient denied the facts, the initial reading of the computed tomography (CT) scan confirmed the presence of multiple images compatible with drug pellets, which were mostly in the stomach. The pellet findings were more consistent with body packing than body stuffing as initially suspected by the police. However, upon admission to our secured inpatient ward for clinical surveillance of pellet evacuation, the patient denied again having ingested such pellets, and declared that he only ate ‘fufu’. Fufu is a traditional food of central and western Africa consisting of a starchy preparation compacted by hand into small balls. Fufu balls are usually swallowed without chewing to allow a sensation of stomach fullness throughout the day. Considering the fufu intake history, a careful reassessment of the imaging confirmed the presence of food content. Conclusions: This case study offers an example of suspected intrabody concealment of illicit substances, which turned out to be false positive due to fufu. It illustrates the importance of a history of food intake that could bias the interpretation of CT scan images.</ns3:p

Access to treatment in prison: an inventory of medication preparation and distribution approaches

The preparation and distribution of medication in prisons or jails are critical for individuals to access their treatment. This process is resource-intensive for healthcare professionals and may violate principles of confidentiality, autonomy, respect, and dignity if non-qualified staff are involved. However, there are no published best practices on the topic. This report aims to bridge this gap by presenting the results of a mapping exercise on different models of medication preparation and delivery. Authors call upon healthcare professionals to enrich this live document to inform health services research further and improve access to prescribed medications for people experiencing incarceration.</ns4:p

A scoping review of ‘Pacing’ for management of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS): lessons learned for the long COVID pandemic

Background: Controversy over treatment for people with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a barrier to appropriate treatment. Energy management or pacing is a prominent coping strategy for people with ME/CFS. Whilst a definitive definition of pacing is not unanimous within the literature or healthcare providers, it typically comprises regulating activity to avoid post exertional malaise (PEM), the worsening of symptoms after an activity. Until now, characteristics of pacing, and the effects on patients’ symptoms had not been systematically reviewed. This is problematic as the most common approach to pacing, pacing prescription, and the pooled efficacy of pacing was unknown. Collating evidence may help advise those suffering with similar symptoms, including long COVID, as practitioners would be better informed on methodological approaches to adopt, pacing implementation, and expected outcomes. Objectives: In this scoping review of the literature, we aggregated type of, and outcomes of, pacing in people with ME/CFS. Eligibility criteria: Original investigations concerning pacing were considered in participants with ME/CFS. Sources of evidence: Six electronic databases (PubMed, Scholar, ScienceDirect, Scopus, Web of Science and the Cochrane Central Register of Controlled Trials [CENTRAL]) were searched; and websites MEPedia, Action for ME, and ME Action were also searched for grey literature, to fully capture patient surveys not published in academic journals. Methods: A scoping review was conducted. Review selection and characterisation was performed by two independent reviewers using pretested forms. Results: Authors reviewed 177 titles and abstracts, resulting in 17 included studies: three randomised control trials (RCTs); one uncontrolled trial; one interventional case series; one retrospective observational study; two prospective observational studies; four cross-sectional observational studies; and five cross-sectional analytical studies. Studies included variable designs, durations, and outcome measures. In terms of pacing administration, studies used educational sessions and diaries for activity monitoring. Eleven studies reported benefits of pacing, four studies reported no effect, and two studies reported a detrimental effect in comparison to the control group. Conclusions: Highly variable study designs and outcome measures, allied to poor to fair methodological quality resulted in heterogenous findings and highlights the requirement for more research examining pacing. Looking to the long COVID pandemic, our results suggest future studies should be RCTs utilising objectively quantified digitised pacing, over a longer duration of examination (i.e. longitudinal studies), using the core outcome set for patient reported outcome measures. Until these are completed, the literature base is insufficient to inform treatment practises for people with ME/CFS and long COVID

Skeletal and dental changes following functional regulator therapy on class II patients

Craniofacial growth in 100 patients treated with the functional regulator of Frankel for about 24 months was compared with craniofacial growth seen in a matched group of untreated persons with Class II malocclusion. Both conventional and geometric cephalometric analyses were used to evaluate the skeletal and dental adaptations. This study shows several clear effects of treatment in either of two age ranges considered. The principal skeletal effect was advancement of the mandible along the direction of the facial axis. This advancement resulted in increases in mandibular length and in vertical facial dimensions. There was little effect of treatment upon maxillary skeletal structures with the exception of point A, which moved slightly posteriorly. Dentoalveolar adaptations due to treatment included a decrease in the normal forward movement of the upper molar and an increase in the normal vertical movement of the lower molar. There was a 2-mm posterior movement of the tip of the upper incisor but minimal anterior tipping of the lower incisor.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/25601/1/0000148.pd