Attitudes, stressors and work outcomes related to the COVID-19 pandemic among dental assistants in Germany: a cross-sectional study.

OBJECTIVES: The COVID-19 pandemic has posed great challenges to medical professionals worldwide. Dental assistants (DAs) are at exceptionally high risk of infection with SARS-CoV-2 due to frequent and close patient contact and involvement in various high-risk dental procedures. This study aimed to investigate attitudes, stressors and work outcomes among DAs from all over Germany at the peak of cases in spring 2020. DESIGN: Cross-sectional study. Descriptive analysis and logistic regression. SETTING: Dental, maxillofacial surgery and orthodontic practices across Germany, April 2020. PARTICIPANTS: Participants aged 18 years and above and currently working as DAs in Germany. PRIMARY AND SECONDARY OUTCOME MEASURES: A self-devised online questionnaire was employed comprising questions on SARS-CoV-2-related attitudes, stressors and work outcomes. Validated scales assessed symptoms of depression and anxiety. RESULTS: Among 1481 participating DAs (median age 35 years, 98.4% female, 91.8% working in dental practices), major stressors were uncertainty about the pandemic's temporal scope (97.9% agreement, n=1450), uncertainty about one's financial situation (87.8%, n=1301), uncertainty about how to act correctly (87.6%, n=1298) and thoughts about a possible infection during work (83.8%, n=1241). Forty-two per cent of DAs (n=622) felt sufficiently prepared for dealing with patients with SARS-CoV-2. Only 17.5% (n=259) agreed that material for personal protection was sufficiently available. Multivariable logistic regression analyses suggested that working in a dental practice, compared with orthodontic and maxillofacial surgery practices, was significantly associated with uncertainty about one's financial situation (OR 2.13 (95% CI 1.33 to 3.44)) and with the reported availability of personal protective equipment (PPE) (0.55 (0.36 to 0.84)). CONCLUSIONS: Training about correct behaviour of DAs during future infectious disease outbreaks is needed, especially for DAs working in dental practices. In the future, it will also be necessary to strengthen supply chains to ensure that PPE is sufficiently available in a timely manner.

Orthorexic eating behavior in vegans is linked to health, not to animal welfare.

PURPOSE: This study aimed to analyze the association between the importance of several reasons to follow a vegan diet and the degree of orthorexic eating behavior in a sample of vegan individuals (N = 65, 53.8% women, age: M = 28.22 (SD = 9.13) years, BMI: M = 22.91 (SD = 3.44) kg/m2). RESULTS: The results reveal that orthorexic eating behavior is associated with the importance of the underlying motives health, esthetics and healing, whereas animal welfare, politics and ecology are not linked to orthorexia. CONCLUSION: Hence, this study reveals that a vegan lifestyle is not per se associated with orthorexic eating behavior, but rather that it varies with the underlying motivation for following a vegan diet.

Meta-analysis of the efficacy of psychological and medical treatments for binge-eating disorder.

OBJECTIVE: To provide a comprehensive meta-analysis on the efficacy of psychological and medical treatments for binge-eating disorder (BED), including those targeting weight loss. METHOD: Through a systematic search before March 2018, 81 published and unpublished randomized-controlled trials (RCTs), totaling 7,515 individuals with BED (Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition [DSM-IV] and Fifth Edition [DSM-5]), were retrieved and analyzed using random-effect modeling. RESULTS: In RCTs with inactive control groups, psychotherapy, mostly consisting of cognitive-behavioral therapy, showed large-size effects for the reduction of binge-eating episodes and abstinence from binge eating, followed by structured self-help treatment with medium-to-large effects when compared with wait-list. Pharmacotherapy and pharmacological weight loss treatment mostly outperformed pill placebo conditions with small effects on binge-eating outcome. These results were confirmed for the most common treatments of cognitive-behavioral therapy, self-help treatment based on cognitive-behavioral therapy, and lisdexamfetamine. In RCTs with active control groups, there was limited evidence for the superiority of one treatment category or treatment. In a few studies, psychotherapy outperformed behavioral weight loss treatment in short- and long-term binge-eating outcome and led to lower longer-term abstinence than self-help treatment, while combined treatment revealed no additive effect on binge-eating outcome over time. Overall study quality was heterogeneous and the quality of evidence for binge-eating outcome was generally very low. CONCLUSIONS: This comprehensive meta-analysis demonstrated the efficacy of psychotherapy, structured self-help treatment, and pharmacotherapy for patients with BED. More high quality research on treatments for BED is warranted, with a focus on long-term maintenance of therapeutic gains, comparative efficacy, mechanisms through which treatments work, and complex models of care. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

The Dusseldorf Illustrated Schema Questionnaire for Children (DISC)

Abstract Childhood experiences are considered to be of crucial importance in the formation of maladaptive schemas, according to Young's concept. Although some schema questionnaires already exist for children, these instruments differ in their schema structures with between 8 and 12 identified factors. To obtain a deeper understanding of early maladaptive schemas in childhood an instrument based on Young's 18-schema model was constructed (Dusseldorf Illustrated Schema Questionnaire for Children (DISC)). Cartoons were designed which represented each schema, providing children with a visual impression of what was meant by the schema, and thus the questions that they had to answer. The items were phrased as self-report statements and children's approval of the statements was assessed using a 4-point rating scale. The resulting preliminary questionnaire (18 cartoons, 90 items) was presented in classrooms across different school types (N = 569, between 8 and 13 years). A confirmatory factor analysis (CFA) was performed on this data to confirm the factorial structure of the questionnaire and to reduce the number of items to two items per schema. The DISC in its final version included 36 items and showed a sufficiently high test-retest reliability and convergent validity when assessed in comparison to another schema questionnaire for children. In addition, the present test is of predictive value since the DISC sum score correlated with ratings on the children's behavioral problems. CFA showed a satisfactory goodness-of-fit based on the original 18-factor model, providing a compact instrument to assess schema representations and to evaluate the dynamics of maladaptation during child development.

Meta-analysis of the effectiveness of psychological and medical treatments for binge-eating disorder (MetaBED): study protocol.

INTRODUCTION: Binge-eating disorder (BED) was included as its own diagnostic entity in the Fifth Edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). An increasing number of treatment studies have been published, but an up-to-date comprehensive meta-analysis on diverse treatment approaches for BED is lacking. In an updated and extension of a previous meta-analysis, the goals of this study are to assess the short-term and long-term effectiveness of psychological and medical treatments for BED. METHODS AND ANALYSIS: We will search bibliographic databases and study registries, including manual searches for studies published before January 2016. The search strategy will include terms relating to binge eating and diverse forms of psychological and medical interventions. Language will be restricted to English. The studies included will be treatment studies, that is, randomised-controlled trials, and non-randomised and non-controlled studies, for individuals with BED (DSM-IV or DSM-5), and studies that provided a pre-treatment and at least one post-treatment or follow-up assessment of binge eating. The primary outcomes will be the number of binge-eating episodes, abstinence from binge eating and diagnosis of BED at post-treatment and/or follow-up(s), and changes from pre-treatment to post-treatment and/or follow-up(s). Likewise, as secondary outcomes, eating disorder and general psychopathology, quality of life, and body weight will be analysed and adverse events and treatment drop-out will be examined. Study search, selection and data extraction, including risk of bias assessment, will be independently performed by 2 reviewers and consensus will be sought. Moderator analyses will be conducted, and equity aspects will be considered. Sensitivity analyses will be conducted to determine the robustness of the results. ETHICS AND DISSEMINATION: Ethical approval is not required for this meta-analysis. Published in a peer-reviewed journal and disseminated electronically and in print, this meta-analysis will form the basis of the renewal of the German evidence-based S3 Guidelines of Diagnosis and Treatment of Eating Disorders, specifically BED. TRIAL REGISTRATION NUMBER: CRD42016043604.

Effects of the menstrual cycle on auditory event-related potentials.

Gonadal steroids (estradiol and progesterone) can alter neuronal functioning, but electrophysiological evidence in women is still sparse. Therefore, the present study investigated event-related potentials (ERPs) to neutral stimuli over the course of the menstrual cycle. In addition, associations between ERPs and salivary estradiol and progesterone concentrations were investigated. Eighteen young healthy women were tested at three different phases of their menstrual cycle (menses, and follicular and luteal phases). ERPs (i.e., the N1 and P2 components, reflecting cortical arousal and the orienting response, the N2, P3, and the Slow Wave (SW), reflecting controlled processing) were measured using two different paradigms. In the luteal phase, early ERPs reflecting the cortical arousal response were diminished in the first stimulus block indicating an attenuated orienting response. These changes were significantly correlated with estradiol as well as progesterone levels. As to the later ERP components, the N2 latency was shorter during menses compared to the other two phases. No menstrual cycle-associated changes were apparent in other late ERP components. In sum, this study documents changes in auditory ERPs across the menstrual cycle with the most prominent changes occurring during the luteal phase. Future ERP studies therefore need to be more attentive to the issue of menstrual phase when studying female subjects or female patients.