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Background: Hirschsprung's disease (HD) may result in an impaired quality of life (QoL) due to bowel problems, postoperative complications and other health-related issues. The Hirschsprung and Anorectal Malformation Quality of Life (HAQL) questionnaire is a disease-specific instrument developed in the Netherlands to measure the QoL in patients with HD and anorectal malformations. The aim of this study was to translate, culturally adapt and validate HAQL in a Danish Hirschsprung population. Material and methods: Translation and cultural adaptation were performed according to international guidelines. Invitations to participate in the validation were sent to 401 patients operated for HD during the period from 1985 to 2012. A total of 156 patients completed the translated and culturally adapted Danish versions of HAQL and 35 parents of children and adolescents completed the corresponding parent questionnaire. Reliability was evaluated in terms of internal consistency using Cronbach's α and test–retest reliability using Intraclass Correlation Coefficient for the retest step. Known groups comparison was performed with comparison of mild HD (defined as recto-sigmoidal HD) and serious HD (defined as more proximal disease). Results: The internal consistency of the dimensions was overall satisfactory for adults and adolescents but more problematic for children, where Cronbach's α was less than 0.7 in 60% of the dimensions. For both children and adolescents, the α-value was unsatisfactory for social functioning, emotional functioning, and body image. The test–retest reliability was overall good. The known groups comparison was only able to demonstrate a significant difference between mild and severe HD within one dimension. Conclusions: The translated version of the HAQL questionnaires provides an overall reliable instrument for evaluating disease-specific QoL in a Danish HD population, but it is important to acknowledge the limitations of the questionnaire, especially in children and adolescents. [ABSTRACT FROM AUTHOR]

Loneliness is a common experience with major negative consequences for well-being. Although much research has examined protective and risk factors for loneliness, we know little about its cultural underpinnings. The few studies that exist seem paradoxical, suggesting that loneliness is higher in cultures where tighter and more demanding (i.e., more restrictive) cultural norms about social relationships decrease the risk of social isolation. At the same time, loneliness is lower among individuals who hold more restrictive norms or perceive such norms among others around them. We move beyond previous research by generating the culture-loneliness framework, suggesting that loneliness occurs across all levels of restrictiveness, but through different predominant types of isolation. More restrictive (i.e., more, tighter, or more demanding) norms about social relationships may better protect from physical isolation (i.e., a lack of social interaction or relationships) but increase the likelihood of emotional and perceived isolation (i.e., a lack of individually satisfying relationships or relationships that do not fulfill cultural ideals). We evaluate this framework by reviewing research at both the individual and the cultural levels, and discuss its theoretical and practical implications. [ABSTRACT FROM AUTHOR]

A case study is presented on patient with a tailgut cyst prolapsing through the anus, with information on the typical presentation and symptoms of this congenital malformation. Topics include the causes of a prolapse through the anus; the diagnosis and treatment of rectal prolapse; and the various forms of presacral and enteric tailgut cysts.

Objective: Drugs targeting the glucose-dependent insulinotropic polypeptide (GIP) receptor (GIPR) are emerging as treatments for type-2 diabetes and obesity. GIP acutely decreases serum markers of bone resorption and transiently increases bone formation markers in short-term clinical investigations. However, it is unknown whether GIP acts directly on bone cells to mediate these effects. Using a GIPR-specific antagonist, we aimed to assess whether GIP acts directly on primary human osteoclasts and osteoblasts. Methods: Osteoclasts were differentiated from human CD14+ monocytes and osteoblasts from human bone. GIPR expression was determined using RNA-seq in primary human osteoclasts and in situ hybridization in human femoral bone. Osteoclastic resorptive activity was assessed using microscopy. GIPR signaling pathways in osteoclasts and osteoblasts were assessed using LANCE cAMP and AlphaLISA phosphorylation assays, intracellular calcium imaging and confocal microscopy. The bioenergetic profile of osteoclasts was evaluated using Seahorse XF-96. Results: GIPR is robustly expressed in mature human osteoclasts. GIP inhibits osteoclastogenesis, delays bone resorption, and increases osteoclast apoptosis by acting upon multiple signaling pathways (Src, cAMP, Akt, p38, Akt, NFκB) to impair nuclear translocation of nuclear factor of activated T cells-1 (NFATc1) and nuclear factor-κB (NFκB). Osteoblasts also expressed GIPR, and GIP improved osteoblast survival. Decreased bone resorption and improved osteoblast survival were also observed after GIP treatment of osteoclast--osteoblast co-cultures. Antagonizing GIPR with GIP(3-30)NH2 abolished the effects of GIP on osteoclasts and osteoblasts. Conclusions: GIP inhibits bone resorption and improves survival of human osteoblasts, indicating that drugs targeting GIPR may impair bone resorption, whilst preserving bone formation. [ABSTRACT FROM AUTHOR]

Simple Summary: The aim of this study was to investigate how health-related quality of life at time of diagnosis is associated with the completion of planned first-line oncological treatment among lung cancer patients. Patients with reduced function and patients who reported fatigue, pain, appetite loss, and financial difficulties at time of diagnosis had significantly increased adjusted odds ratios for not completing the planned first-line oncological treatment. Measures of lung cancer patients' self-reported HRQOL as part of the diagnostic evaluation at time of diagnosis may contribute to the optimization of planned oncological treatment. Experts recommend assessing lung cancer patients' health-related quality of life (HRQOL) in the diagnostic evaluation. We investigated the association between HRQOL and completion of first-line treatment among lung cancer patients in a prospective cohort study. Clinical information on lung cancer patients was obtained from medical records, and information on quality of life and lung cancer-related symptoms was obtained through questionnaires at time of diagnosis. We used directed acyclic graphs to identify potential confounders and mediators between HRQOL and completion of first-line treatment. The association between functioning levels and symptoms and completion of first-line oncological treatment was estimated as odds ratios, with 95% confidence intervals, in logistic regression models. In all, 137 patients (52% men, mean age: 69 years) participated, out of 216 invited. Patients who reported reduced functioning had significantly increased ORs for not completing first-line treatment: poor physical function (OR 4.44), role function (OR 6.09), emotional function (OR 5.86), and social function (OR 3.13). Patients with fatigue (OR 7.55), pain (OR 6.07), appetite loss (OR 4.66), and financial difficulties (OR 17.23) had significantly increased ORs for not completing the first-line treatment. Reduced functioning and presence of symptoms were associated with not completing first-line treatment. An assessment of HRQOL could potentially aid the diagnostic evaluation and treatment planning for lung cancer patients. [ABSTRACT FROM AUTHOR]

Aims: The alpha-glucosidase inhibitor acarbose is believed to reduce plasma glucose by delaying hydrolysis of carbohydrates. Acarbose-induced transfer of carbohydrates to the distal parts of the intestine increases circulating glucagon-like peptide 1 (GLP-1). Using the GLP-1 receptor antagonist exendin(9-39)NH2, we investigated the effect of acarbose-induced GLP-1 secretion on postprandial glucose metabolism in patients with type 2 diabetes. Methods: In a double-blinded, placebo-controlled, randomized, crossover study, 15 participants with metformin-treated type 2 diabetes (age: 57-85 years, HbA1c: 40-74 mmol/mol) were subjected to two 14-day treatment periods with acarbose or placebo, respectively, separated by a 6-week wash-out period. At the end of each period, two randomized 4-h liquid mixed meal tests with concomitant infusion of exendi n(9-39)NH2 and saline, respectively, were performed. Results: Compared to placebo, acarbose increased postprandial GLP-1 concentrations and decreased postprandial glucose. We observed no absolute difference in the exendin(9-39) NH2-induced increase in postprandial glucose excursions between placebo and acarbose periods, but relatively, postprandial glucose was increased by 119 ± 116% (mean ± s.d.) during exendin(9-39)NH2 infusion in the acarbose period vs a 39 ± 27% increase during the placebo period (P = 0.0163). Conclusions: We confirm that acarbose treatment stimulates postprandial GLP-1 secretion in patients with type 2 diabetes. Using exendin(9-39)NH2, we did not see an impact of acarbose-induced GLP-1 secretion on absolute measures of postprandial glucose tolerance, but relatively, the effect of exendin(9-39)NH2 was most pronounced during acarbose treatment. [ABSTRACT FROM AUTHOR]

Sulfonylureas (SUs) provide an efficacious first-line treatment in patients with hepatocyte nuclear factor 1α (HNF1A) diabetes, but SUs have limitations due to risk of hypoglycemia. Treatment based on the incretin hormones glucose-dependent insulinotropic peptide (GIP) and glucagon-like peptide 1 (GLP-1) is characterized by their glucose-dependent insulinotropic actions without risk of hypoglycemia. The effect of SUs together with GIP or GLP-1, respectively, on insulin and glucagon secretion in patients with HNF1A diabetes is currently unknown. To investigate this, 10 HNF1A mutation carriers and 10 control subjects without diabetes were recruited for a double-blinded, placebo-controlled, crossover study including 6 experimental days in a randomized order involving 2-h euglycemic-hyperglycemic clamps with coadministration of: 1) SU (glimepiride 1 mg) or placebo, combined with 2) infusions of GIP (1.5 pmol/kg/min), GLP-1 (0.5 pmol/kg/min), or saline (NaCl). In HNF1A mutation carriers, we observed: 1) hypoinsulinemia, 2) insulinotropic effects of both GIP and GLP-1, 3) additive to supra-additive effects on insulin secretion when combining SU+GIP and SU+GLP-1, respectively, and 4) increased fasting and arginine-induced glucagon levels compared with control subjects without diabetes. Our study suggests that a combination of SU and incretin-based treatment may be efficacious in patients with HNF1A diabetes via potentiation of glucose-stimulated insulin secretion. [ABSTRACT FROM AUTHOR]

• The first study to investigate the impact of the GET Ahead training on women's empowerment. • We focus on three aspects of women's empowerment. • We compare female borrowers invited to training with their husband, alone. • Training participation improved women's empowerment in the medium run. • Results show no additional impacts of inviting husbands to training. Across the world the Gender and Entrepreneurship Together (GET Ahead) training originally developed by the International Labour Organization has been implemented to improve business outcomes and enhance women's empowerment. This randomized controlled trial is the first rigorous attempt to examine the impact of the GET Ahead training on women's empowerment. We focus on the impact of offering this training to female microfinance borrowers of TYM, the largest microfinance organization in North Vietnam. A major contribution of this study is that it focuses on different dimensions of women's empowerment: (1) personal empowerment, measured by control beliefs, and (2) relational empowerment, measured by relational friction and intra-household decision making power. This study also stands out in that we explicitly study whether involving husbands affects the impact of the training. We find that the GET Ahead training improves women's empowerment on all three aspects: increased control beliefs and intra-household decision making power (only on larger expenditures), and decreased relational friction. However, the results on relational frictions should be taken with care due to possible underreporting. Moreover, in general, we find no additional impacts of inviting husbands to the training. Finally, our results suggest that it takes some time before the training starts to improve women's empowerment. We observe no short-term but only mid-term effects from before the training to 12 months after the training. [ABSTRACT FROM AUTHOR]

The alpha-glucosidase inhibitor acarbose is an antidiabetic drug delaying assimilation of carbohydrates and, thus, increasing the amount of carbohydrates in the distal parts of the intestines, which in turn increases circulating levels of the gut-derived incretin hormone glucagon-like peptide 1 (GLP-1). As GLP-1 may suppress bone resorption, acarbose has been proposed to potentiate meal-induced suppression of bone resorption. We investigated the effect of acarbose treatment on postprandial bone resorption in patients with type 2 diabetes and used the GLP-1 receptor antagonist exendin(9-39)NH 2 to disclose contributory effect of acarbose-induced GLP-1 secretion. In a randomised, placebo-controlled, double-blind, crossover study, 15 participants with metformin-treated type 2 diabetes (2 women/13 men, age 71 (57–85 years), BMI 29.7 (23.6–34.6 kg/m2), HbA1c 48 (40–74 mmol/mol)/6.5 (5.8–11.6 %) (median and range)) were subjected to two 14-day treatment periods with acarbose and placebo, respectively, separated by a six-week wash-out period. At the end of each period, circulating bone formation and resorption markers were assessed during two randomised 4-h liquid mixed meal tests (MMT) with infusions of exendin(9-39)NH 2 and saline, respectively. Glucagon-like peptide 2 (GLP-2) was also assessed. Compared to placebo, acarbose impaired the MMT-induced suppression of CTX as assessed by baseline-subtracted area under curve (P = 0.0037) and nadir of CTX (P = 0.0128). During acarbose treatment, exendin(9-39)NH 2 infusion lowered nadir of CTX compared to saline (P = 0.0344). Neither parathyroid hormone or the bone formation marker procollagen 1 intact N-terminal propeptide were affected by acarbose or GLP-1 receptor antagonism. Acarbose treatment induced a greater postprandial GLP-2 response than placebo treatment (P = 0.0479) and exendin(9-39)NH 2 infusion exacerbated this (P = 0.0002). In patients with type 2 diabetes, treatment with acarbose reduced postprandial suppression of bone resorption. Acarbose-induced GLP-1 secretion may contribute to this phenomenon as the impairment was partially reversed by GLP-1 receptor antagonism. Also, acarbose-induced reductions in other factors reducing bone resorption, e.g. glucose-dependent insulinotropic polypeptide, may contribute. • Alpha-glucosidase inhibition increases postprandial glucagon-like peptide 1 (GLP-1) secretion. • This has been suggested to potentiate postprandial suppression of bone resorption during alpha-glucosidase inhibition. • We used a GLP-1 receptor antagonist during alpha-glucosidase inhibitor treatment to elucidate this. • The alpha-glucosidase inhibitor acarbose reduced postprandial suppression of bone resorption. • GLP-1 receptor antagonism reversed acarbose's effect on postprandial bone resorption. [ABSTRACT FROM AUTHOR]

Abstract: Eating disorders (EDs) comprise a variety of symptoms and have a profound impact on everyday life. They are associated with high morbidity and mortality. The objective of this study was to analyse published data on health-related quality of life (HRQoL) in EDs so as to compare the results to general population norm data and to investigate potential differences between ED diagnostic groups. A systematic review of the current literature was conducted using a keyword-based search in PubMed and PsychInfo. The search covered anorexia nervosa (AN), bulimia nervosa (BN), eating disorders not otherwise specified (EDNOS) and binge eating disorder (BED) and used the Medical Outcomes Study Short Form-36 Health Survey (SF-36) as a measure of HRQoL. Of the 102 citations identified, 85 abstracts were reviewed and seven studies were included in the meta-analysis. AN patients were included in five studies (n=227), BN in four studies (n=216), EDNOS in two studies (n=166) and BED in four studies (n=148). We tested for between-study variation and significant differences between the diagnostic groups. The results confirmed a significantly lower level of HRQoL in all EDs compared to a population mean. It was not possible to establish any differences between the diagnostic groups. [Copyright &y& Elsevier]

Abstract: Following realistic group-conflict theory, negative interdependence between groups (e.g., competition) leads to prejudice towards the opposing outgroup. Based on research on mindset priming, it is hypothesized that competition increases prejudice, regardless of whether the derogated outgroup is involved in the competition or not. In Experiment 1, participants remembered an event involving either competition or cooperation; in Experiments 2 and 3 they participated in a competitive, cooperative, or individual assessment of their knowledge. Subsequent measures indicated that competition results in higher levels of prejudice, even when it is not related to the intergroup context. Additional evidence suggests that this effect is not driven by the transfer of negative affect or ego-depletion. Possible underlying cognitive processes are discussed. [Copyright &y& Elsevier]

Background and Objective: Studies in humans and mice have demonstrated that the gut hormone glucagon-like peptide 2 (GLP-2) promotes gallbladder relaxation and refilling. Here, we assessed the effect of exogenous GLP-2 on gallbladder motility in the fasted state of healthy men with and without infusion of the potent gallbladder-contracting hormone cholecystokinin (CCK)., Methods: In a randomized, double-blind, placebo-controlled, crossover study, 15 male participants (mean [SD]: age 24.7 [3.6] years; body mass index 22.9 [1.6] kg/m2) underwent four experimental days receiving two infusions on each day: either CCK (0.4 pmol × kg-1 × min-1, time 0-180 min) + GLP-2 (10 pmol × kg-1 × min-1, time 30-240 min), CCK + placebo, placebo + GLP-2, or placebo + placebo, respectively. Gallbladder volume was measured at baseline and throughout the 4-hour study day using ultrasonography., Results: Compared to placebo + placebo, GLP-2 + placebo did not affect gallbladder volume, but when infused in combination with CCK, GLP-2 completely abolished the strong gallbladder-contracting effect seen during CCK + placebo infusion, restoring baseline levels of gallbladder volume., Conclusion: Exogenous GLP-2 counteracts exogenous CCK-induced gallbladder emptying in healthy men, pointing to a possible therapeutic potential for GLP-2 as a relaxing modulator of gallbladder smooth muscle tone (e.g., as bridge to surgery in biliary colic). The effect may also explain the gallbladder-related adverse events reported for GLP-2 receptor agonists used in the treatment of short bowel syndrome., (© The Author(s) 2024. Published by Oxford University Press on behalf of the Endocrine Society. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com. See the journal About page for additional terms.)

Nostalgia is a social, self-relevant, and bittersweet (although mostly positive) emotion that arises when reflecting on fond past memories and serves key psychological functions. The majority of evidence concerning the prevalence, triggers, and functions of nostalgia has been amassed in samples from a handful of largely Western cultures. If nostalgia is a fundamental psychological resource, it should perform similar functions across cultures, although its operational dynamics may be shaped by culture. This study ( N = 2,606) examined dispositional nostalgia, self-reported triggers of nostalgia, and functions of experimentally induced nostalgia in young adults across 28 countries and a special administrative region of China (i.e., Hong Kong). Results indicated that nostalgia is frequently experienced across cultures, albeit better valued in more-developed countries (i.e., higher national wealth and life-expectancy). Nostalgia is triggered by psychological threats (especially in warmer countries), sensory stimuli (especially in more-developed countries), and social gatherings (especially in less-developed countries). The positive or negative affect prompted by experimentally induced nostalgia varied by country, but was mild overall. More importantly, recalling a nostalgic (vs. ordinary) memory increased social connectedness, self-continuity, and meaning in life across cultures. In less-developed countries, recalling an ordinary memory also conferred some of these functions, reducing the effect size of nostalgia. Finally, recalling a nostalgic (vs. ordinary) memory augmented state satisfaction with life in countries with lower quality of living (i.e., lower life-expectancy and life-satisfaction). Overall, findings confirm the relevance of nostalgia across a wide range of cultures and indicate cultural nuances in its functioning. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Learning the host society's language and finding a job are important steps for the societal integration of refugees. Especially language proficiency is a key barrier for the integration of low literates. Often language training and gaining work skills are separated during the integration procedure. We investigated a 1-year pilot program for refugees with low-literacy levels in the Netherlands, which combined language training (daily classes, work-related language) with work experience in sheltered employment (second-hand shop) to facilitate language learning and prepare this group better for the labour market. Building on Ager and Strang's conceptual integration framework (2008), we expected that this combined program should improve agency (communication strategies, preparedness for the labour market) via intergroup contact at work. We used a mixed-method approach to follow the development of participants ( N =10) longitudinally (baseline, after 6 months, after 11 months). We gathered questionnaire data, interviewed teachers and students, and observed interactions in classes and at work. Overall, use of communication strategies increased. Analyzing individual cases (profiles) offered nuanced insights into for whom and why the program seems to have differential impact, especially in terms of labour market preparation. We discuss results and the importance of creating intergroup contact to facilitate integration in a new society., Supplementary Information: The online version contains supplementary material available at 10.1007/s12134-023-01028-6., (© The Author(s) 2023, corrected publication 2023.)

Introduction: Critical incidents in ambulance work are not easily compared to other risk occupations. Understanding types of incidents that can be considered critical in operational ambulance work is important to prevent work-related post-traumatic stress (PTS)., Aim: This study aimed to develop a scale of critical incidents in ambulance work and assess its predictive validity in relation to the severity of PTS symptoms., Methods: A total of 1092 open-ended descriptions from Danish ambulance personnel were content analysed to develop a categorical scale that identifies types of events perceived as critical to operative ambulance personnel. Multiple regression was used to assess whether the scale predicted PTS symptoms and to assess the cumulative effect of exposure to these events., Results: The study found that the 1092 descriptions of critical events could be condensed into 28 categories of critical events. These ranged from life-threatening situations and deaths, to more daily events such as handling strong emotional reactions from patients' relatives and working with terminally ill children. The frequency of events significantly predicted the severity of PTS symptoms with low to moderate effect (std beta = 0.2, t(375) = 3.7, p < .001), even when adjusting for known risk factors for post-traumatic stress disorder., Conclusion: This study showed that critical events in ambulance work included events that are not normally considered traumatic, and indicated that understanding the cumulative effect of these events is important when trying to prevent traumatic sequalae in ambulance personnel. The study highlighted the importance of increased focus on non-traumatic incidents that have an ongoing impact on paramedics' mental health and well-being. The Critical Incidents Scale for Ambulance Work - Denmark (CISAW-D) is a promising tool for systematic screening for exposure to critical events in ambulance work., Competing Interests: None declared., (© 2022 The Author(s).)

Although research indicates that specialized sexual assault (SA) services are effective in terms of promoting postassault recovery and improving legal outcomes, little is known about how to best support survivors facing co-occurring difficulties and inequalities (e.g., preexisting mental health issues, substance abuse, poverty). This deficiency in knowledge was also expressed by service providers at Danish SA centers (SACs), who described this using the term "vulnerable survivors." Therefore, the present study aims to address this knowledge gap by exploring (a) how service providers understand vulnerability in the context of SA and (b) how service provision is currently approached for these survivors. Interviews were conducted with 18 service providers representing five professional groups (psychologists, social workers, forensic doctors, nurses, police) and analyzed using Interpretative Phenomenological Analysis. A total of eight themes emerged from the analysis, including service providers' descriptions of what characterizes vulnerability in survivors and broader perspectives on service provision for these survivors. Survivors considered least likely to attain desired supports were also those perceived to be most vulnerable with regards to risk and experiences surrounding sexual victimization (e.g., individuals with preexisting mental health issues). Service providers also believed that a large proportion of those served experience ongoing vulnerabilities that are difficult to manage within existing support models. The results thus suggest that survivors' needs cannot be met if vulnerabilities are overlooked or ignored. At the same time, the concept of vulnerability warrants caution since vulnerabilities are often placed within individual survivors, but the formal support system also appears vulnerable in its ability to meet the diverse needs and priorities of those served. The implications for SA services across the globe are discussed, including a need for more individually tailored and trauma-informed responses to SA that simultaneously address co-occurring difficulties and inequalities in survivors.

Introduction: Police officers are frequently exposed to potentially traumatic events at work that increases risk of developing mental health problems, in particular post-traumatic stress disorder (PTSD). Individual and organisational factors may influence the detrimental effects of cumulative exposure to traumatic events. Occupational stress and lack of organisational support are associated with increased risk of PTSD among police officers. The Are You All right? (AYA) project is a prospective cohort study investigating the cumulative effect of traumatic events at work on mental health problems and absenteeism among police officers. The study also investigates whether potential risk and protective factors modify the association of traumatic events at work with mental health problems and absenteeism., Method and Analysis: The AYA-study includes the entire Danish police force. Prospective survey data are collected over a 3-year period beginning in the spring of 2021. Electronic surveys are sent out at baseline with 1-year, 2-year and 3-year follow-up. Further, short surveys are sent out every third month, covering exposure to traumatic events and current mental health status. The survey data are paired with workplace register data on sickness absence. Register data on sickness absence cover the period from 2020 to 2025., Ethics and Dissemination: This study was presented for evaluation at the National Ethics Committee in Denmark (reference number: 20202000-216), but according to Danish legislation, survey studies do not require approval by official Danish scientific or ethical committees. Participation in the project is based on informed consent, and data are handled in accordance with the Danish data legislation (journal number: 20/41457). Results are published in scientific journals and disseminated at international conferences., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Intimate partner violence (IPV) affects thousands of women around the world and is prevalent in the Global South. Unequal social structures perpetuate hierarchies and maintain women's vulnerability to violence. Difficulties women face in accessing education, economic resources, and employment diminish their power in intimate relationships, increasing the likelihood of IPV. These factors can also have a significant effect on women's mental health. However, some studies show that economic empowerment does not necessarily translate into greater agency for women if they cannot use the resources they earn to pursue whatever goals or values they regard as important in life. Agency is women's ability to identify their life goals and act upon them through critical evaluation (intrinsic agency) and autonomous decision-making (instrumental agency). In this article, we aim to analyze the relationship between women's power (educational and economic) and agency and their influence on intimate partner violence and on women's mental health in the context of El Salvador. Currently, El Salvador has one of the highest percentages of femicide worldwide. We used data from the first national survey on violence against women in El Salvador to determine empowerment indicators and investigated their influence on intimate partner violence and women's mental health. Results from a representative sample of 1,274 women aged between 15 and 64 years old and, using a structural equation modeling revealed that education was a protective factor against IPV, but economic power appeared to put women at greater risk of IPV. Education was positively related to both intrinsic and instrumental agency, but only instrumental agency was negatively associated with the likelihood of being a victim of IPV. Finally, both intrinsic and instrumental agencies were positively related to women's mental health. We discuss the importance of identifying specific factors related to women's power and agency to prevent IPV and mental health problems and to promote more gender equity in the Global South., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Navarro-Mantas, de Lemus, García-Sánchez, McGill, Hansen and Megías.)

The domestic cat (Felis catus) is among the most popular companion animals and most abundant carnivores globally. It is also a pet with an immense ecological footprint because even non-feral and food-subsidized cats can be prolific predators. Whereas knowledge about the spatial behavior of individual domestic cats is growing, we still know little about how a local population of free-ranging pet cats occupies the landscape. Using a citizen science approach, we GPS-tagged 92 pet cats with outdoor access living in a residential area in southern Norway. The resulting position data allowed us to construct both individual home range kernels and a population-level utilization distribution. Our results reveal a dense predatory blanket that outdoor cats drape over and beyond the urban landscape. It is this population-level intensity surface-the "catscape"-that potential prey have to navigate. There were few gaps in the catscape within our residential study area and therefore few terrestrial refuges from potential cat predation. However, cats spent on average 79% of their outdoor time within 50 m to their owner's home, which suggests that the primary impact is local and most acute for wildlife in the vicinity to homes with cats. We discuss the catscape as a conceptual and quantitative tool for better understanding and mitigating the environmental impact of domestic cats., (© 2022. The Author(s).)

Background: Lanthanum carbonate is a phosphate binder used in advanced kidney disease. Its radiopaque appearance has been described in many case studies and case series. Misinterpretation of this phenomenon leads to unnecessary diagnostic tests and procedures. The objectives of this study were to summarize the literature on lanthanum carbonate opacities and present a visual overview., Methods: A systematic search was conducted using MEDLINE, Embase, and Web of Science. We included all types of studies, including case reports/studies, describing radiological findings of lanthanum carbonate opacities in patients with chronic kidney disease. No filter for time was set., Results: A total of 36 articles were eligible for data extraction, and 33 articles were included in the narrative synthesis. Lanthanum carbonate opacities were most commonly reported in the intestines (26 studies, 73%), stomach (8 studies, 21%), and the aerodigestive tract (2 studies, 6%). The opacities in the intestine were most frequently described as multiple, scattered radiopaque densities, compared with the aerodigestive tract, where the opacities were described as a single, round foreign body. Suspicion of contrast medium or foreign bodies was the most common differential diagnosis. LC opacities in patients with CKD are commonly misinterpreted as foreign bodies or suspect contrast media., Conclusions: CKD patients treated with LC may have opacities throughout the digestive tract that can vary in appearance. Stopping LC treatment or changing to an alternative phosphate binder prior to planned image studies can avoid diagnostic confusion. If this is not an option, knowledge of the presentation of LC opacities is important.

Migration elicits mixed reactions from the host-society. Negative responses towards migrants seem to emerge when migrants are perceived as culturally different. We investigated when and why perceived cultural distance (PCD) is associated with negative migrant attitudes by focussing on differences in cultural values. We expected that PCD in social values (focus on relationships and society) should be more strongly associated with attitudes towards migrants than personal values (individual needs and gains) and should be mediated by symbolic threat. In two quasi-experimental studies (N = 200, N = 668) with Dutch participants (host-society), we simultaneously tested effects of respondents' perception of Dutch values, their perceptions of migrant values (of Moroccan, Syrian, Polish ethnic origin), and PCD between Dutch-migrant value on attitudes. For all migrant groups, PCD in social values was associated with more negative attitudes, less tolerance, and less policy support regarding migrants; this was mediated by symbolic threat. These links were weaker for personal values., (© 2021 The Authors. British Journal of Social Psychology published by John Wiley & Sons Ltd on behalf of British Psychological Society.)

Despite having an aglomerular kidney, Gulf toadfish can survive in water ranging from nearly fresh up to 70 parts per thousand salinity. In hyperosmotic environments, the major renal function is to balance the passive Mg 2+ load from the environment with an equal excretion. However, the molecular transporters involved in Mg 2+ secretion are poorly understood. We investigated whether environmental MgCl 2 alone or in combination with elevated salinity affected transcriptional regulation of genes classically involved in renal Mg 2+ secretion (slc41a1, slc41a3, cnnm3) together with three novel genes (trpm6, trpm7, claudin-19) and two isoforms of the Na + /K + -ATPase α-subunit (nka-α1a, nka-α1b). First, toadfish were acclimated to 5, 9, 35, or 60 ppt water (corresponding to ~ 7, 13, 50 and 108 mmol L -1 ambient [Mg 2+ ], respectively) and sampled at 24 h or 9 days. Next, the impact of elevated ambient [Mg 2+ ] was explored by exposing toadfish to control (50 mmol L -1 Mg 2+ ), or elevated [Mg 2+ ] (100 mmol L -1 ) at a constant salinity for 7 days. Mg 2+ levels in this experiment corresponded with levels in control and hypersaline conditions in the first experiment. A salinity increase from 5 to 60 ppt stimulated the level of all investigated transcripts in the kidney. In Mg 2+ -exposed fish, we observed a 14-fold increase in the volume of intestinal fluids and elevated plasma osmolality and [Mg 2+ ], suggesting osmoregulatory challenges. However, none of the renal gene targets changed expression compared with the control group. We conclude that transcriptional regulation of renal Mg 2+ transporters is induced by elevated [Mg 2+ ] in combination with salinity rather than elevated ambient [Mg 2+ ] alone., (© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Introduction: Working in emergency medicine in rural areas may entail challenges due to absence of medical backup, difficulties in logistics, lack of healthcare system coordination, and, potentially, feelings of loneliness. The aim of this study was to elucidate the experiences of physicians working in an emergency medical setting in a rural area in Northern Sweden., Methods: A qualitative study was performed based on semi-structured interviews. Six physicians were interviewed. The interviews were transcribed and analysed using the systematic text condensation method., Results: Rural physicians described thriving in the rural environment. Four main themes were identified as important to their wellbeing and job satisfaction. They described close relations to the nearest referral centre, where they felt connected to the personnel in the centre. The participants described this as a crucial factor aiding their everyday work in emergency medicine. The rural physicians underlined educational and professional development individually, in teams training sessions, and through the locally created rural residency program for rural GPs as important. They expressed an adaptability to the rural environment and described having a problem-solving attitude. Additionally they found a functional transport system crucial as part of their workflow., Conclusion: Overall, the rural physicians thrived in the rural environment where interpersonal relations and creative initiatives along with a customised rural residency program prepared the physicians to work in rural areas. Despite the long distances between hospitals and health clinics, the physicians rarely felt alone in the field and the general well-functioning transport system with possibility for improvisations aided them in medical emergencies.

Introduction: A recent study in mice points to the gut-derived hormone glucagon-like peptide 2 (GLP-2) as an important regulator of gallbladder motility inducing gallbladder relaxation and refilling. In this study, we evaluated the effect of exogenous GLP-2 on postprandial gallbladder motility in healthy men., Methods: In a randomized, double-blinded, placebo-controlled, crossover study, we evaluated the effect of 4-hour intravenous infusions of high-dose GLP-2 (10 pmol × kg × min), low-dose GLP-2 (1 pmol × kg × min), and placebo (saline) on postprandial gallbladder motility. A 300-kcal liquid-mixed meal (added 1.5 g of acetaminophen for indirect measurement of gastric emptying) was served 30 minutes after start of intravenous infusions. Gallbladder volume was assessed by ultrasonography., Results: Fifteen healthy men, age 24.3 (22.4-26.1) years (mean [95% confidence interval]) and body mass index 22.5 (21.7-23.4) kg × m, were included. Basal plasma GLP-2 concentration was 14 (11-17) pmol/L. During low-dose and high-dose GLP-2 infusions, steady-state postprandial plasma GLP-2 concentrations amounted to 201 (188-214) and 2,658 (2,443-2,873) pmol/L, respectively, compared with maximum postprandial plasma GLP-2 concentration of 34 (25-44) pmol/L during placebo. Gallbladder emptying (assessed as baseline-subtracted area under the curve for gallbladder volume) was reduced by low-dose GLP-2 (-0.8 [0.7-1.9] L × min, P < 0.0001) and nearly abolished by high-dose GLP-2 (1.3 [-1.7 to 0.01] L × min, P = 0.029) compared to placebo (-2.0 [-2.8 to -1.1] L × min). Compared to placebo, gastric emptying was reduced by high-dose GLP-2 (P = 0.0060 and 0.019), whereas low-dose GLP-2 did not affect gastric emptying (P = 0.13 and 0.85)., Discussion: Exogenous GLP-2 exerts a dose-dependent inhibitory effect on postprandial gallbladder emptying in healthy men.

Research has mainly studied women's empowerment assessing personal (e.g., self-esteem) or relational (e.g., decision-making) empowerment indicators. Women are not isolated individuals; they are embedded in social relationships. This is especially relevant in more collectivist societies. The current research provides a relational perspective on how husbands may hamper women's empowerment by inflicting intimate partner violence (IPV) assessing women's self-reported experience. We tested the link between self-esteem and experienced IPV on financial intra-household decision-making power among women entrepreneurs (N = 1,347) in Northern Vietnam, a collectivistic society undergoing economic development. We report two measurement points. As expected, self-esteem (and not IPV) was positively related to more power in intra-household decision-making on small expenditures, which are traditionally taken by women. However, IPV (and not self-esteem) was related to less decision-making power on larger expenditures, traditionally a domain outside women's power. We test and discuss the directionality of the effects and stress the importance of considering women's close relationship when investigating signs of women's empowerment., (© 2019 The Authors. British Journal of Social Psychology published by John Wiley & Sons Ltd on behalf of British Psychological Society.)

This study examined intimate partner stalking experienced by 196 mothers stalked by the father of their children. Respondents completed a questionnaire concerning experiences of stalking and level of support by the authorities. Results revealed higher rates of harassing than violent stalking. In many cases, the children were also targeted by the stalking. Encounters with several agencies were common, but respondents were often not recognized as victims of stalking and demoralized by extensive case proceedings. This study calls for a special sensitivity of professionals encountering stalked parents in their work and highlights a need for coordination and cooperation among multiple agencies.

Objective: Excessive alcohol consumption is a leading cause of global morbidity and mortality. However, knowledge of the biological factors that influence ad libitum alcohol intake may be incomplete. Two large studies recently linked variants in the KLB locus with levels of alcohol intake in humans. KLB encodes β-klotho, co-receptor for the liver-derived hormone fibroblast growth factor 21 (FGF21). In mice, FGF21 reduces alcohol intake, and human Fgf21 variants are enriched among heavy drinkers. Thus, the liver may limit alcohol consumption by secreting FGF21. However, whether full-length, active plasma FGF21 (FGF21 (1-181)) levels in humans increase acutely or sub-chronically in response to alcohol ingestion is uncertain., Methods: We recruited 10 healthy, fasted male subjects to receive an oral water or alcohol bolus with concurrent blood sampling for FGF21 (1-181) measurement in plasma. In addition, we measured circulating FGF21 (1-181) levels, liver stiffness, triglyceride, and other metabolic parameters in three healthy Danish men before and after consuming an average of 22.6 beers/person/day (4.4 g/kg/day of ethanol) for three days during Oktoberfest 2017 in Munich, Germany. We further correlated fasting FGF21 (1-181) levels in 49 healthy, non-alcoholic subjects of mixed sex with self-reports of alcohol-related behaviors, emotional responses, and problems. Finally, we characterized the effect of recombinant human FGF21 injection on ad libitum alcohol intake in mice., Results: We show that alcohol ingestion (25.3 g or ∼2.5 standard drinks) acutely increases plasma levels of FGF21 (1-181) 3.4-fold in fasting humans. We also find that binge drinking for three days at Oktoberfest is associated with a 2.1-fold increase in baseline FGF21 (1-181) levels, in contrast to minor deteriorations in metabolic and hepatic biomarkers. However, basal FGF21 (1-181) levels were not correlated with differences in alcohol-related behaviors, emotional responses, or problems in our non-alcoholic subjects. Finally, we show that once-daily injection of recombinant human FGF21 reduces ad libitum alcohol intake by 21% in mice., Conclusions: FGF21 (1-181) is markedly increased in circulation by both acute and sub-chronic alcohol intake in humans, and reduces alcohol intake in mice. These observations are consistent with a role for FGF21 as an endocrine inhibitor of alcohol appetite in humans., (Copyright © 2018 The Authors. Published by Elsevier GmbH.. All rights reserved.)

Background: Fitness exercise is popular and associated with improved health and social status. Taken to extremes, however, exercise can become an addiction. One suggested symptom of exercise addiction is "conflicts" with family and friends. However, it may be difficult to recognize excessive exercise patterns if they are accepted and encouraged by relatives. The aim of this study was to explore if fitness exercisers with a high risk of addiction experienced the same level of exercise support as exercisers with a low risk of addiction. Furthermore, we wanted to examine if social support affected the subjective reporting of "conflicts"., Method: A total of 577 fitness exercisers completed the Exercise Addiction Inventory (EAI) and two questions asking about "exercise support from family and friends" and "present eating disorder"., Results: Exercisers at high risk of exercise addiction reported the same level of support from relatives as those at low risk. Exercisers with high levels of exercise support reported significantly fewer conflicts, even if they were at high risk of addiction. If an eating disorder was present, the level of exercise support was significantly reduced., Conclusion: Exercise addiction might be difficult to identify with the general behavioral addiction symptom "conflict", since exercise is socially accepted even in subjects with high risk of exercise addiction. If an eating disorder is present, the exercise routines seem to be interpreted as socially undesirable. Screening for exercise addiction with the EAI should take into account that fitness exercisers rarely report conflicts, which could result in false negative cases.

Type 1 diabetes (T1D) is an autoimmune disorder caused by inflammatory destruction of the pancreatic tissue. The etiopathogenesis and characteristics of the pathologic process of pancreatic destruction are well described. In addition, the putative susceptibility genes for T1D as a monoglandular disease and the relation to polyglandular autoimmune syndrome (PAS) have also been well explored. The incidence of T1D has steadily increased in most parts of the world, especially in industrialized nations. T1D is frequently associated with autoimmune endocrine and non-endocrine diseases and patients with T1D are at a higher risk for developing several glandular autoimmune diseases. Familial clustering is observed, which suggests that there is a genetic predisposition. Various hypotheses pertaining to viral- and bacterial-induced pancreatic autoimmunity have been proposed, however a definitive delineation of the autoimmune pathomechanism is still lacking. In patients with PAS, pancreatic and endocrine autoantigens either colocalize on one antigen-presenting cell or are expressed on two/various target cells sharing a common amino acid, which facilitates binding to and activation of T cells. The most prevalent PAS phenotype is the adult type 3 variant or PAS type III, which encompasses T1D and autoimmune thyroid disease. This review discusses the findings of recent studies showing noticeable differences in the genetic background and clinical phenotype of T1D either as an isolated autoimmune endocrinopathy or within the scope of polyglandular autoimmune syndrome.

Nostalgia is a frequently experienced complex emotion, understood by laypersons in the United Kingdom and United States of America to (a) refer prototypically to fond, self-relevant, social memories and (b) be more pleasant (e.g., happy, warm) than unpleasant (e.g., sad, regretful). This research examined whether people across cultures conceive of nostalgia in the same way. Students in 18 countries across 5 continents (N = 1,704) rated the prototypicality of 35 features of nostalgia. The samples showed high levels of agreement on the rank-order of features. In all countries, participants rated previously identified central (vs. peripheral) features as more prototypical of nostalgia, and showed greater interindividual agreement regarding central (vs. peripheral) features. Cluster analyses revealed subtle variation among groups of countries with respect to the strength of these pancultural patterns. All except African countries manifested the same factor structure of nostalgia features. Additional exemplars generated by participants in an open-ended format did not entail elaboration of the existing set of 35 features. Findings identified key points of cross-cultural agreement regarding conceptions of nostalgia, supporting the notion that nostalgia is a pancultural emotion.

Introduction: This study explored whether health-related quality of life (HRQOL) changes following Roux-en-Y gastric bypass surgery were associated with identifiable socio-demographic or clinical characteristics, and it examined the impact on health outcomes of changes in the Danish criteria for bariatric surgery., Material and Methods: Participants (n = 55) completed the Short Form Health Survey v2 (SF-36) before and 22 ± 4.2 months after surgery. Information on socio-demographics, body mass index (BMI), co-morbidity and satisfaction with surgery were collected through patient questionnaires and hospital records., Results: There was overall improvement on all SF-36 subscales and in the mean physical score (PCS) and mean mental score (MCS) (p = 0.001). A total of five patients had lower PCS and 13 patients had lower MCS after surgery, but we identified no particular characteristics associated with this poorer outcome. Co-morbidity and preoperative PCS/MCS showed a strong correlation with change in PCS/MCS score., Conclusion: Gastric bypass had a positive overall effect on HRQOL, but further investigation of individual variations is needed. We found no significant differences in HRQOL outcome between those patients who would be accepted for bariatric surgery under the current Danish criteria for bariatric surgery and those patients who only fulfilled the criteria for bariatric surgery before 2011., Funding: not relevant., Trial Registration: ClinicalTrials.gov: NCT02032199.

Upon joining a new social category, group members strive to establish and maintain high social identification. Thus far, we know relatively little about the cognitive underpinnings of social identification when developing from a new to a well-established group member. This research investigates the differential impact of newcomers' self-stereotyping (i.e., assimilation of the self to group stereotypes) and self-anchoring (i.e., projection of self-attributes onto the ingroup) on the development of social identification over time. Across two time points during the academic year, first year psychology students (N = 123) filled in a questionnaire on their perceptions about the self, psychology students, and social identification. Cross-sectional and longitudinal analyses confirmed our hypotheses that self-anchoring instigated new group members' social identification, while self-stereotyping instigated social identification once group membership was more well-established. This research emphasizes the interactive role of the personal and social self in the development of social identification., (© 2013 The British Psychological Society.)

Majority members often react negatively to efforts to stimulate diversity. An important reason for this is that in diverse groups, majority members' own group bond is typically based on perceived prototypicality, which serves to disregard those who are different. In the present research we investigate how majority members' pro-diversity beliefs may be enhanced, by experimentally manipulating how the self is cognitively defined in relation to a diverse group. Specifically, we hypothesize that majority members' focus on the personal self (i.e., self-anchoring) rather than the social self (i.e., self-stereotyping) when creating a group bond may facilitate their pro-diversity beliefs and positive attitudes toward minority members. In two experiments we manipulated self-anchoring and self-stereotyping via mindset priming among ethnic majority members in diverse teams. As expected, results showed that relative to self-stereotyping, majority members' self-anchoring enhanced pro-diversity beliefs and positive attitudes toward minority members.

The present paper investigates how people identify with groups depending on the clarity of a group's identity content. According to self-categorization theory, self-stereotyping (i.e., projection of group prototypes onto self) should be the cognitive process underlying social identification. We argue, however, that this is only plausible in clearly defined groups. If a group is unclear in terms of its identity content, we argue that self-anchoring (i.e., projection of personal self onto group) accounts for social identification. In line with these hypotheses, two studies (with minimal and real groups) reveal that self-anchoring positively predicts the level of social identification and entitativity in unclearly, but not clearly defined groups. Conversely, self-stereotyping positively predicts the level of social identification in clearly, but not unclearly defined groups. Together, these findings are the first to demonstrate the differential impact of cognitive projection processes on social identification depending on group clarity., (© 2012 The British Psychological Society.)

Research on targets' affective reactions to social discrimination has not yet addressed self- and other-directed anger at the same time. Four studies tested the hypothesis that the perceived cause of negative feedback moderates the impact of social identification on self-directed anger. In Studies 1 and 2, high levels of social identification led to less self-directed anger when negative feedback was attributed to social discrimination but not when it was attributed either to other external causes or internally. In Study 3, a cross-lagged design showed that higher identification led to less self-directed anger when negative feedback was attributed to social discrimination but not the other way around. This effect was found using scenarios (Studies 1-3) and also when using the recollection of personal experiences to manipulate attribution (Study 4). These results indicate that following social discrimination, social identification protects the self and does not increase individual vulnerability.

Objective: To evaluate the safety and long-term effectiveness of a new treatment for snoring using permanent palatal implants., Study Design: Prospective study with 35 patients referred to the clinic for the treatment of snoring. The patients were followed for 1 year, and a sleep analysis was performed and repeated at 360 days. During the procedure, 3 braided polyethylene terephthalate implants were placed in the palate of each patient., Results: The average duration for nonnarcotic analgesics was 1.3 days. No adverse events were observed. The mean snoring intensity was reduced from 7.1 at baseline to 4.8 at 1 year (P < 0.001). Bed partner satisfaction rate was very high at 70.6% after 1 year. Six patients (17.8%) experienced a total of 9 partial extrusions., Conclusions: The palatal implant system is safe, and the effectiveness in treating snoring is comparable to other surgical methods. Advantages are virtually no tissue damage and minimal patient discomfort as a result of one standardized, low-cost procedure., Ebm Rating: C-4.