Veterans Administration Readjustment Counseling Service Counselors' Training Needs: Results of a National Needs Assessment.

The Department of Veteran Affairs established Readjustment Counseling Service (RCS) to meet the mental health needs of active-duty service members, veterans, and their families. A diverse therapeutic skill set is needed to serve this complex population. To assess training needs, a national mixed-methods needs assessment consisting of a survey for RCS counselors and focus groups among counselors, RCS educational trainers, and national leadership was conducted. Survey results (n = 681) showed that RCS counselors were most interested in trainings on moral injury, acceptance and commitment therapy, and military sexual trauma (MST). Desired trainings aligned with populations served. Themes from focus groups revealed the need for foundational trainings so that all RCS counselors are adept in treating MST, moral injury, and posttraumatic disorder and proficient in caring for couples. Additionally, counselors desired advanced trainings tailored to individual counselors' needs. RCS counselors identified multiple trainings to help them treat those they serve.

Uncovering Potentially Therapeutic Phytochemicals, In silico Analysis, and Biological Assessment of South-Chinese Red Dragon Fruit (Hylocereus polyrhizus).

Red dragon fruit is gaining popularity globally due to its nutritional value and bioactive components. The study aimed to assess the phytochemical, nutritional composition, antioxidant, antibacterial, and cytotoxic properties of extracts from the South Chinese red dragon fruit peel, flesh, and seeds. Extract fractions with increasing polarity (ethyl acetate

Training Residents in High-Value, Cost-Effective Care: a National Survey of Psychiatry Program Directors.

OBJECTIVE: The goal of this study was to explore how prepared psychiatry programs are to teach residents to practice resource management and high-value, cost-effective care. METHODS: An anonymous online survey was sent to 187 psychiatry training directors between July and September 2015. RESULTS: Forty-four percent of training directors responded to the survey. While most training directors who responded (88%) agreed that that graduate medical education has a responsibility to respond to the rising cost of health care, fewer than half agreed that that their faculty members consistently model cost-effective care (48%), that residents have access to information regarding the cost of tests and procedures (32%), and that residents are prepared to integrate the cost of care with available evidence when making medical decisions (44%). Only 11% reported providing training in resource management. Barriers cited to teaching cost-effective care included a lack of information regarding health care costs (45%), a lack of time (24%), a lack of faculty with relevant skills (19%), and competing training demands and priorities (18%). Training directors also noted a lack of available curricular resources and assessment tools (21%). Another 12% cited concerns about cost containment overriding treatment guidelines. Ninety percent of training directors agreed that they would be interested in resources to help teach high-value, cost-effective care. CONCLUSIONS: Most psychiatry programs do not provide formal training in resource management but are interested in resources to teach high-value, cost-effective care. Curricula for residents and faculty may help meet this need.

Mailed Outreach Is Superior to Usual Care Alone for Colorectal Cancer Screening in the USA: A Systematic Review and Meta-analysis.

Mailed outreach promoting colorectal cancer (CRC) screening with a stool blood test kit may increase participation, but magnitude and consistency of benefit of this intervention strategy is uncertain. Our aim was to conduct a systematic review and meta-analysis of randomized controlled trials (RCTs) comparing mailed outreach offering stool tests to usual care, clinic-based screening offers on CRC screening uptake in the USA. We performed a systematic literature search of five databases for RCTs of mailed outreach from January 1980 through June 2017. Primary outcome was screening completion, summarized using random-effects meta-analysis as pooled differences in proportion completing the screening and relative risk of achieving screening compared to control. Subgroup analyses by test type offered-fecal immunochemical test (FIT) or guaiac fecal occult blood test (gFOBT), the presence of telephone reminders, and the presence of predominant underserved/minority population within study were performed. Quality of evidence was evaluated using the GRADE framework. Seven RCTs which enrolled 12,501 subjects were included (n = 5703 assigned mailed outreach and n = 6798 usual care). Mailed outreach resulted in a 28% absolute (95% CI 25-30%; I2 = 47%) and a 2.8-fold relative (RR 2.65, 95% CI 2.03-3.45; I2 = 92%) increase in screening completion compared to usual care, with a number needed to invite estimated to be 3.6. Similar outcomes were observed across subgroups. Overall body of evidence was at moderate quality. Mailed outreach offering a gFOBT or FIT is associated with a large and consistent increase in CRC screening completion and should be considered for more widespread implementation for improving screening rates nationwide.

Assessment of different washing treatments to mitigate imidacloprid and acetamaprid residues in spinach.

BACKGROUND: Agricultural crops treated with pesticides retain toxic residues that can cause various health disorders upon consumption. The present research project was designed to assess pesticide residues in contaminated spinach (Spinacia oleracea). The efficiency of chemical solutions (acetic acid, citric acid, hydrogen peroxide, sodium chloride and sodium carbonate) of different concentrations (% w/v) along with tap water for the dissolution of pesticide residues in spinach was studied. After various dipping treatments (T0 -T22 ) of treated spinach, imidacloprid and acetamaprid residues were determined by high-performance liquid chromatography (HPLC). RESULTS: Among the solutions tested, the highest reductions in imidacloprid and acetamaprid residues respectively were 0.92 ± 0.04 mg kg(-1) (83%) and 1.42 ± 0.53 mg kg(-1) (87%) in treatment T6 (10% acetic acid), followed by 0.79 ± 0.01 mg kg(-1) (69%) and 0.86 ± 0.05 mg kg(-1) (71%) in treatment T11 (10% citric acid), while the lowest were 0.30 ± 0.02 mg kg(-1) (27%) and 0.35 ± 0.02 mg kg(-1) (29%) in treatment T20 (4% sodium carbonate). Moreover, treatment T1 (tap water) caused 0.27 ± 0.00 mg kg(-1) (23%) and 0.38 ± 05 mg kg(-1) (27%) elimination of imidacloprid and acetamaprid residues respectively. CONCLUSION: From these findings it is inferred that acetic acid and citric acid washing treatments can be used along with tap water to minimize pesticide residues in treated vegetables. © 2015 Society of Chemical Industry.

Glycoalkaloids (α-chaconine and α-solanine) contents of selected Pakistani potato cultivars and their dietary intake assessment.

Glycoalkaloids (α-solanine and α-chaconine) are naturally occurring toxic compounds in potato tuber (Solanum tuberosum L.) that cause acute intoxication in humans after their consumption. Present research was conducted to evaluate α-chaconine, α-solanine, and total glycoalkaloids (TGAs) contents in the peel and flesh portions by high-performance liquid chromatography method in selected Pakistani potato cultivars. The α-solanine content varies 45.98 ± 1.63 to 2742.60 ± 92.97 mg/100 g of dry weight (DW) in peel and from 4.01 ± 0.14 to 2466.56 ± 87.21 mg/100 g of DW in flesh. Similarly, α-chaconine content varied from 4.42 ± 0.16 to 6818.40 ± 211.07 mg/100 g of DW in potato peel and from 3.94 ± 0.14 to 475.33 ± 16.81 mg/100 g DW in flesh portion. The TGA concentration varied from 177.20 ± 6.26 to 5449.90 ± 192.68 mg/100 g of DW in peel and from 3.08 ± 0.11 to 14.69 ± 0.52 mg/100 g of DW in flesh portion of all the potato cultivars tested. All the potato cultivars contained lower concentration of TGA than the limits recommended as safe, except 2 cultivars, that is FD8-3 (2539.18 ± 89.77 mg/100 g of DW) and Cardinal (506.16 ± 17.90 mg/kg). The dietary intake assessment of potato cultivars revealed that Cardinal, FD 35-36, FD 8-3, and FD 3-9 contained higher amount of TGA in whole potato, although FD 8-3 only possessed higher content of TGA (154.93 ± 7.75) in its flesh portion rendering it unfit for human consumption. Practical Application: This paper was based on the research conducted on toxic compounds present in all possible potato cultivars in Pakistan. Actually, we quantify the toxic compounds (glycoalkaloids) of potato cultivars through HPLC and their dietary assessment. This paper revealed safety assessment and their application in food industries especially potato processing.

Utilization of dairy byproduct proteins, surfactants, and enzymes in frozen dough.

Use of natural additives is gaining popularity among the masses as they are becoming more conscious about their diet and health. Frozen dough products are one of the recent examples of value-added cereal products which face stability problems during extended storage periods of times. Dairy whey proteins, surfactants, and certain enzymes are considered important natural additives which could be used to control the water redistribution problem in the dough structure during the storage condition. They interact with the starch and gluten network in a dough system and thus behave as dough improvers and strengtheners. These natural additives not only help to bind extra moisture but also to improve texture and sensory attributes in frozen dough bakery products.