A pilot randomized controlled trial of online acceptance and commitment therapy versus compassion-focused therapy for chronic illness.

Literature suggests that acceptance and commitment therapy (ACT) is effective in improving well-being and in reducing psychopathological symptoms commonly experienced by people with chronic illness (CI). Compassion-focused therapy (CFT) reduces psychological distress, especially in individuals with high levels of shame and self-criticism, but few studies have explored CFT in CI. Additionally, studies almost exclusively compared ACT and CFT with inactive controls (wait-list; treatment as usual). Also, there is an interest in developing cost-effective mental health solutions, such as low-intensity online psychological interventions. This randomized controlled trial (RCT) aimed to assess the acceptability and compare the efficacy of four-session online ACT (n = 25) and CFT (n = 24) interventions in a sample of people with CI. Results showed both interventions were acceptable, with attrition rates at post-intervention comparable to those found in similar studies (around 50%). Intention-to-treat analyses showed that participants presented significantly less illness-related shame, less uncompassionate self-responding and more valued living after the intervention, although no difference was found between conditions. Results were sustained at 3- and 6-month follow-up. Results did not find statistical differences between conditions through reliable change index (RCI). Correlation between demographics and RCI showed that, at post-intervention, younger participants presented more behavioural awareness, men presented more valued action, and participants with CI for shorter periods presented less uncompassionate self-responding and less anxiety. Results suggest that low-intensity (four sessions) online ACT and CFT are cost-effective approaches to promote mental health of individuals with CI. Results and limitations are thoroughly discussed.

Carcass traits and meat quality of lambs slaughtered during different seasonal conditions.

This study was conducted to evaluate the effects of slaughtering feedlot Texel lambs during different climatic conditions on carcass and meat quality traits. Twenty castrated male Texel lambs (21.8 ± 0.62 kg) were distributed to two treatments according to the climatic conditions during the finishing period and at pre-slaughter: warm season (WS; mean temperature of 23.4 °C and 77.5% relative humidity) and cool season (CS; mean temperature of 14.9 °C and 79.5% relative humidity). During the pre-slaughter, thermal comfort was evaluated through the variables: respiratory frequency, rectal temperature, temperature of the ocular region, and temperature-humidity index (THI). After the finishing period, lambs were slaughtered, and carcass and meat quality traits were assessed. The THI values indicate that animals harvested in the WS spent 13 h of the day under potential thermal discomfort conditions in the week before slaughter and in the pre-slaughter period, whereas lambs harvested in the CS did not experience any thermal discomfort. Slaughter weight, carcass weight, carcass dressing, and backfat thickness were greater (P ≤ 0.03), whereas cooling losses were lower (P < 0.01) for lambs slaughtered in the CS. Moreover, thawing losses were lower (P < 0.01), whereas cooking losses were greater (P < 0.01) for lambs harvested in the CS. Lambs slaughtered in the CS also showed greater meat redness, yellowness, and chroma values (P < 0.05). Although carcass traits were affected by the greater thermal discomfort exposure, meat quality of lambs was less impacted by the climatic conditions at slaughter.

A Theory- and Evidence-Based Digital Intervention Tool for Weight Loss Maintenance (NoHoW Toolkit): Systematic Development and Refinement Study.

BACKGROUND: Many weight loss programs show short-term effectiveness, but subsequent weight loss maintenance is difficult to achieve. Digital technologies offer a promising means of delivering behavior change approaches at low costs and on a wide scale. The Navigating to a Healthy Weight (NoHoW) project, which was funded by the European Union's Horizon 2020 research and innovation program, aimed to develop, test, and evaluate a digital toolkit designed to promote successful long-term weight management. The toolkit was tested in an 18-month, large-scale, international, 2×2 factorial (motivation and self-regulation vs emotion regulation) randomized controlled trial that was conducted on adults with overweight or obesity who lost ≥5% of their body weight in the preceding 12 months before enrollment into the intervention. OBJECTIVE: This paper aims to describe the development of the NoHoW Toolkit, focusing on the logic models, content, and specifications, as well as the results from user testing. METHODS: The toolkit was developed by using a systematic approach, which included the development of the theory-based logic models, the selection of behavior change techniques, the translation of these techniques into a web-based app (NoHoW Toolkit components), technical development, and the user evaluation and refinement of the toolkit. RESULTS: The toolkit included a set of web-based tools and inputs from digital tracking devices (smart scales and activity trackers) and modules that targeted weight, physical activity, and dietary behaviors. The final toolkit comprised 34 sessions that were distributed through 15 modules and provided active content over a 4-month period. The motivation and self-regulation arm consisted of 8 modules (17 sessions), the emotion regulation arm was presented with 7 modules (17 sessions), and the combined arm received the full toolkit (15 modules; 34 sessions). The sessions included a range of implementations, such as videos, testimonies, and questionnaires. Furthermore, the toolkit contained 5 specific data tiles for monitoring weight, steps, healthy eating, mood, and sleep. CONCLUSIONS: A systematic approach to the development of digital solutions based on theory, evidence, and user testing may significantly contribute to the advancement of the science of behavior change and improve current solutions for sustained weight management. Testing the toolkit by using a 2×2 design provided a unique opportunity to examine the effect of motivation and self-regulation and emotion regulation separately, as well as the effect of their interaction in weight loss maintenance.

Co-contamination of food products from family farms in an environmental disaster area in Southeast Brazil with pathogenic bacteria and enteric viruses.

In the present study, we evaluated the degree of contamination of fresh vegetables, cheeses and jellies from disaster area in Brazil with bacteria and enteric viruses. Food samples (n = 350) were tested for Escherichia coli, Salmonella spp., Listeria monocytogenes, Staphylococcus spp., and enteric viruses (rotavirus A (RVA), human adenovirus (HAdV), hepatitis A virus (HAV), and human norovirus (HNoV). E. coli was present in 56% of the samples, Salmonella spp. was present in 14% of the samples, L. monocytogenes and Staphylococcus spp. (coagulase-positive) were present in 36% of the samples. The enteric viruses RVA and HAdV were detected in cheeses and vegetables.

Modified Micromarsupialization as Treatment of Ranula in a Pediatric Patient.

Ranulas are mucoceles located on the floor of the mouth. The main form of treatment for these lesions is surgical excision, but this can lead to complications such as hemorrhage, recurrence of the lesion, and damage to the lingual nerve. Thus, other therapeutic modalities are indicated, such as modified micromarsupialization, which is a simple technique and not associated with recurrences, and without the need of a new intervention in the postoperative period. An 11-year-old female child, nonwhite, presented with bubble-shaped lesion located on floor of the mouth, on the left side, with exophytic growth, sessile base, bluish coloration, measuring about 4.0 cm in diameter, showing well-defined limits, well-delimited contours and borders, smooth surface, and softened consistency. Under the diagnostic hypothesis of the ranula, a modified micromarsupialization was performed. After 90 days of observation, complete regression and repair of the lesion were observed, without recurrence. Modified micromarsupialization is a simple therapeutic modality, low cost, and well-tolerated by the patient, mainly the pediatric one, being considered very effective in the treatment of lesions of difficult clinical management, as the ranula.

Cognitive fusion and depressive symptoms in women with chronic pain: A longitudinal growth curve modelling study over 12 months.

This study aims to (a) explore individual differences in women with chronic pain (CP) in regard to pain intensity, functional impairment, cognitive fusion, and depressive symptoms and (b) longitudinally test whether cognitive fusion is a significant predictor of depression symptoms, while controlling for pain intensity and functional impairment, over a 12-month period. This study follows a longitudinal design and was conducted in a sample of 86 women with CP who responded to an online battery of questionnaires in three equally spaced assessment moments. In order to explore the growth trajectory of variables of interest, latent growth curve models were examined. Also, correlation analyses were conducted between demographic and illness-related variables and depressive symptoms, as well as between all variables in all assessment moments. Cognitive fusion and functional impairment (but not pain intensity) were significantly associated with baseline levels of depressive symptoms. Cognitive fusion significantly predicted the growth trajectory of depressive symptoms, whereas pain intensity and functional impairment did not. No demographic (age, marital status, education, socio-economic) nor illness-related variables (number of CP diagnoses, duration of CP, taking medication) were associated with depressive symptoms at any point. These results suggest that the trajectory of depressive symptoms in women with CP is not predicted by the intensity of pain nor pain-related functional impairment, but rather by the tendency to get entangled with internal experiences (e.g., thoughts, emotions, and physical sensations), which may or may not be related to pain-specific contents. Clinical implications are discussed.

Mindfulness, selfcompassion, and depressive symptoms in chronic pain: The role of pain acceptance.

OBJECTIVE(S): The aim of this study was to test a theory driven model in which pain acceptance (both pain willingness [PW] and activity engagement [AE]) mediates the relationships of mindfulness and selfcompassion with depressive symptoms, while controlling for pain intensity. METHODS: A path analysis was conducted using AMOS software to test a meditational model in a sample of women with chronic musculoskeletal pain (N = 231). RESULTS: Participants with higher levels of mindful awareness and selfcompassion presented lower levels of pain intensity and depressive symptoms, and higher levels of AE. PW did not significantly correlate with any variable in study. The mediation analysis showed that AE mediated the relationship between selfcompassion and depressive symptoms, independently from pain intensity. CONCLUSIONS: These findings seem to corroborate the hypothesis that selfcompassion is rooted in a motivational system, as it seems to correlate with less depressive symptoms through increasing the engagement with valued actions despite experiencing pain.

BEfree: A new psychological program for binge eating that integrates psychoeducation, mindfulness, and compassion.

Binge eating disorder (BED) is associated with several psychological and medical problems, such as obesity. Approximately 30% of individuals seeking weight loss treatments present binge eating symptomatology. Moreover, current treatments for BED lack efficacy at follow-up assessments. Developing mindfulness and self-compassion seem to be beneficial in treating BED, although there is still room for improvement, which may include integrating these different but complimentary approaches. BEfree is the first program integrating psychoeducation-, mindfulness-, and compassion-based components for treating women with binge eating and obesity. OBJECTIVE: To test the acceptability and efficacy up to 6-month postintervention of a psychological program based on psychoeducation, mindfulness, and self-compassion for obese or overweight women with BED. DESIGN: A controlled longitudinal design was followed in order to compare results between BEfree (n = 19) and waiting list group (WL; n = 17) from preintervention to postintervention. Results from BEfree were compared from preintervention to 3- and 6-month follow-up. RESULTS: BEfree was effective in eliminating BED; in diminishing eating psychopathology, depression, shame and self-criticism, body-image psychological inflexibility, and body-image cognitive fusion; and in improving obesity-related quality of life and self-compassion when compared to a WL control group. Results were maintained at 3- and 6-month follow-up. Finally, participants rated BEfree helpful for dealing with impulses and negative internal experiences. CONCLUSIONS: These results seem to suggest the efficacy of BEfree and the benefit of integrating different components such as psychoeducation, mindfulness, and self-compassion when treating BED in obese or overweight women. KEY PRACTITIONER MESSAGE: The current study provides evidence of the acceptability of a psychoeducation, mindfulness, and compassion program for binge eating in obesity (BEfree); Developing mindfulness and self-compassionate skills is an effective way of diminishing binge eating, eating psychopathology and depression, and increasing quality of life in women with obesity; Integrating psychoeducation, mindfulness, and compassion seem to be effective in diminishing binge eating, with results maintained up to 6-month postintervention.

Stressors in anaesthesiology: development and validation of a new questionnaire: A cross-sectional study of Portuguese anaesthesiologists.

BACKGROUND: Stress in anaesthesiologists is a common and multifactorial problem related to patients, colleagues and organisations. The consequences of stress include depression, work-home conflicts and burnout. Reduction in stress can be achieved by reducing the number and magnitude of stressors or by increasing resilience strategies. OBJECTIVES: We have created the self-reporting 'Stress Questionnaire in Anaesthesiologists' (SQA), to qualify the sources of stress in anaesthesiologists' professional lives, and measure the level of associated stress. Our study aimed to develop and validate the SQA using exploratory and confirmatory factor analyses. Construct validity was assessed through correlations between SQA and negative psychological outcomes as well as by comparing perception of stress among different known groups. DESIGN: A questionnaire-based cross-sectional, correlational, observational study. SETTINGS: The study was conducted between January 2014 and December 2014, throughout different anaesthesia departments in Portuguese hospitals. Data collection was from a representative subset at one specific time point. PARTICIPANTS: A sample of 710 anaesthesia specialists and residents from Portugal. MAIN OUTCOME MEASURES: The primary outcome measure was to identify specific stressors in anaesthesiologists. Secondary outcome was the association between stressors and burnout, depression symptoms, anxiety, stress, rumination, satisfaction with life and functional impairment. RESULTS: The exploratory analysis showed the SQA is a tri-dimensional instrument and confirmatory analysis showed the tri-dimensional structure presented good model fit. The three dimensions of SQA correlated positively with other stress measures and burnout, but negatively with satisfaction with life. CONCLUSION: SQA is a well adjusted measure for assessing stressors in anaesthesia physicians and includes clinical, organisational and team stress factors. Results showed that the SQA is a robust and reliable instrument.

Epidemiological Profile of Facial Fractures and Their Relationship With Clinical-Epidemiological Variables.

The objective of this study was to identify the epidemiological profile of facial fractures and to associate with clinical-epidemiological variables. An epidemiological survey was conducted in which data retrieved from the records of patients with facial fractures were analyzed. Pearson χ(2) test, Student t-test, one-way analysis of variance, Bonferroni post-hoc test, and logistic regression were used for statistical analysis, adopting a level of significance of 5%. The sample consisted of 718 patients ranging in age from 21 to 30 years (56.4%), including 480 (66.9%) men. Traffic accidents were the main etiological agent (62.7%) and the nasal bones were the most affected (41.8%). An association was observed between age and etiology (P < 0.001), fractured bone (P < 0.001), type of treatment (P < 0.001), hospital length of stay (P < 0.001), and complications (P = 0.001). Patients with traffic accident [odds ratio (OR) = 3.08, P < 0.001] and fall (OR = 2.50, P = 0.049) as etiology had more risk of complications. The type of fractured bone was associated with etiology (P < 0.001), type of treatment (P < 0.001), hospital length of stay (P < 0.001), and complications (maxilla--OR = 1.90, P = 0.004). In conclusion, facial fractures predominantly affect men aged 21 to 30 years. Traffic accidents are the main etiology and the nasal bone is the site most affected. It was observed that the older the patient, the greater the susceptibility to falls, surgical treatment, hospital stay, and complications. Patients with maxillary or mandibular fractures remain hospitalized for longer periods of time. Fractures by traffic accident and fall had more risk of complications. The risk of complications was also higher in patients with maxilla fracture.

Comparison of Resistance to Asiatic Citrus Canker Among Different Genotypes of Citrus in a Long-Term Canker-Resistance Field Screening Experiment in Brazil.

Asiatic citrus canker (ACC) is caused by Xanthomonas citri subsp. citri. The disease results in yield loss and renders fruit unfit for the fresh market. A 6-year study in Paraná State, Brazil, was conducted to compare the susceptibility of 186 genotypes of citrus representing sweet orange (Citrus sinensis), mandarin (C. reticulata), Mediterranean mandarin (C. deliciosa), Clementine mandarin (C. clementina), Satsuma mandarin (C. unshiu), sour orange (C. aurantium), lemon (C. limon), sweet lime (C. aurantifolia), grapefruit (C. paradisi), and four hybrids (C. reticulata × Citrus sp., C. reticulata × C. paradisi, C. reticulata × C. sinensis, and C. unshiu × C. sinensis). Sweet orange (C. sinensis) was represented by the most genotypes (n = 141). The number of lesions per leaf was assessed 18 times from 2005 to 2010 (up to 4 times per year). The data were analyzed using mixed-model analysis of fixed and random effects, which showed a total of six resistance-susceptibility groupings of species and hybrids. Based on species, the most resistant genotypes, on average, included Satsuma and lemon (mean lesions per leaf = 4.32 and 4.26, respectively), and the most susceptible genotypes were grapefruit and sweet lime, with 14.84 and 10.96 lesions per leaf, respectively. Genotypes of mandarin, sour orange, Mediterranean mandarin, and sweet orange had intermediate severity (5.48 to 9.56 lesions per leaf). The hybrids also showed a range of ACC severity but all were in the more resistant groupings (5.26 to 7.35 lesions per leaf). No genotype was immune to ACC. The most resistant genotype was 'Muscia' (C. reticulata) and the most susceptible was 'Valencia Frost' (C. sinensis) (1.86 and 14.78 lesions per leaf, respectively). Approximately one-sixth of the genotypes showed a negative relationship of mean lesions per leaf with time, suggesting increasing resistance as they aged, due to a reduction in either new flush or plant size and structure. These results of the relative susceptibility of different citrus genotypes can be used in future research and to assist in varietal selection or for breeding purposes both within Brazil and other regions where ACC is an issue.

Memories of shame experiences with others and depression symptoms: the mediating role of experiential avoidance.

BACKGROUND: Shame experiences have been suggested to be related with psychopathological symptoms and with self-relevant beliefs. Recent studies also suggest that avoidant-focused strategies (e.g., rumination, thought suppression and dissociation) mediate the impact of shame memories and depression symptoms. However, experiential avoidance has been found to mediate the relation between early experience of abuse and psychopathological symptoms. Our goal was to test the mediating effect of experiential avoidance in the relation between both the nature of shame experiences at the hands of caregivers and the centrality of shame memories with others, and depression symptoms. METHOD: Using structural equation modelling, we assessed the frequency and nature of recalled shame experiences at the hands of caregivers, the centrality of shame experiences with others throughout childhood and adolescence, experiential avoidance and depression symptomatology in 161 participants from general population. RESULTS: Experiential avoidance mediates the impact of shame experiences with caregivers and depression symptoms. Experiential avoidance also mediated the association between the centrality of shame experiences with others and depression symptoms. CONCLUSION: Our results suggest that shame memories with others do not per se impact on depression symptoms, but rather the unwillingness to experience them and the attempts to control them. Hence, our results emphasize the importance of addressing affect regulation processes such as avoidance when dealing with shame memories, particularly with patients who experience depression symptoms. KEY PRACTITIONER MESSAGE: The recall of shame experiences with caregivers is associated with the experience of depression symptoms, even when these experiences are not perceived as central points to one's life identity and story. This seems to suggest a necessity to explore these experiences in a therapeutic setting. Our findings suggest that experiential avoidance is a key process through which these memories of shame experiences impact on depression symptomatology. Hence, it seems to be of great importance to reduce experiential avoidance and help people change the way they relate with these memories.

Vascular endothelial growth factor-like and its receptor in a crustacean optic ganglia: a role in neuronal differentiation?

The neural system appears before the vascular system in the phylogenetic tree. During evolution, vascular system generation takes advantage of the pre-existing vascular endothelial growth factor (VEGF) in order to form its networks. Nevertheless, the role of VEGF in neuronal and glial cells is not yet completely understood. In order to support the hypothesis of a neural role for VEGF, we searched for VEGF- and VEGF receptor (VEGFR)-like immunoreactivities (immunohisto/cytochemistry and Western blotting) in the eyestalk of the invertebrate Ucides cordatus (Crustacea, Brachyura, Ucididae). Our results showed that both neurons and glial cells expressed VEGF-immunoreactivity, and that VEGFR was evidenced in neural cells. This is the first report about the VEGF/VEGFR-like immunoreactivities in the nervous tissue of a crustacean, and enables U. cordatus to be included in the repertoire of animal models used for ascertaining the role of VEGF in the nervous system.

Development and Validation of Standard Area Diagrams as Assessment Aids for Estimating the Severity of Citrus Canker on Unripe Oranges.

Asiatic citrus canker (ACC) is an important disease of citrus in Brazil and elsewhere in the world. Infection with the causal pathogen, Xanthomonas citri subsp. citri, can cause severe disease on the fruit. Visual estimation of severity is the usual method used to quantify ACC on diseased fruit. The objective of this research was to construct and validate standard area diagram (SAD) sets as assessment aids for raters to improve the accuracy and reliability of visual estimates of ACC on unripe (green) fruit of sweet orange. Two SAD sets were constructed. A five-diagram SAD set had five severities depicted (0.5, 2.0, 8.0, 27.0, and 40.0%) and a six-diagram SAD set had six severities depicted (0.5, 1.0, 3.0, 9.0, 20.0, and 40.0%). Fifteen raters evaluated 40 images of cankered, unripe fruit. Both the five- and six-diagram SAD sets significantly improved the accuracy and reliability of estimates. Agreement, measured by Lin's concordance correlation coefficient, was 0.220 to 0.913 when not using SADs, 0.814 to 0.955 when using five-diagram SAD sets, and 0.863 to 0.925 when using six-diagram SAD sets. The five-diagram SAD set was significantly more accurate and reliable compared with the six-diagram set. Possible reasons for this are discussed. Based on the results, the five-diagram SAD set is preferable to use. Although the SAD set was developed for sweet orange, it doubtless has applicability to other citrus, including grapefruit. These SAD sets should be useful for research endeavors where accurate and reliable estimates of the severity of ACC are required.

The Need to Look at Transgender and Gender Diverse People's Health: A Preliminary Descriptive Report on Pain, Sexual Distress, and Health Profile of Five Transmasculine People and One Non-Binary Person with Endometriosis.

The sexual health of transgender and gender diverse (TGD) people with endometriosis has been overlooked, and important emotional experiences, such as sexual distress and its correlates, have been ignored. This has prevented a more comprehensive look at the health experiences of TGD individuals. This descriptive online survey study preliminarily explored the experiences of pain symptoms, sexual distress, and mental health of N = 6 TGD individuals diagnosed with endometriosis. Descriptive results showed a mean delay of 10 years from the onset of symptoms to the diagnosis. Endometriosis-related pain was a common symptom, although with low to moderate intensity. Results also showed higher mean levels of pain impact, powerlessness and lack of control, somatization, depression, anxiety, and sexual distress, and lower mean levels of emotional well-being, social support, and worse self-image compared to reports on cisgender women with endometriosis in the literature. These results suggested that sexual and mental health in the context of TGD people with endometriosis has specificities and may be associated with factors that need to be accounted for to provide comprehensive and socially just healthcare, such as the recognition of the impact of endometriosis treatment on symptoms of gender dysphoria. To achieve sexual health equity for TGD people, continuous and updated professional training and inclusive research with multiple informants are necessary.

Oral Health Education for Children: Development of a Serious Game with a User-Centered Design Approach.

Background: Children can learn efficiently with well-designed serious games. The use of applications to promote health has proliferated, but there is a lack of scientific studies on educational games in oral health. Materials and Methods: We developed the Brazilian version of a British and Jordanian oral health education game for children from the perspectives of Brazilian specialists and users. This descriptive study, with a qualitative and quantitative approach, comprised three phases: I-Experts' discussion of the appropriateness of the previous version of the game to Brazil; II-Development of the first Brazilian version of the game; and III-Evaluation of the first version with 15 children from 4 to 8 years of age. Results: In Phase I, the specialists agreed with the development of the Brazilian version of the game, with minor adjustments on: advice on eating; advice on oral hygiene habits, users' age group, game characters, and game purpose. Phase II: a version with a few changes in images and recommendations, written and spoken in Brazilian Portuguese. Phase III: The global average of correct answers in the game's tasks was 75.3%, ranging from 50.0% to 100%. Children reported having fun with the game, and most understood the content and its interface; their parents found the information relevant and enjoyed the gameplay with their children. Conclusions: The Oral Health Education Game offered basic information for preventing dental caries to Brazilian children aged 4-8 years old in an interactive and fun way; it could support professionals in improving oral health education.

Randomized controlled trial of an Acceptance and Commitment Therapy and compassion-based group intervention for persons with inflammatory bowel disease: the LIFEwithIBD intervention.

Objectives: This study tested the acceptability and efficacy of an Acceptance and Commitment Therapy and compassion-based intervention (LIFEwithIBD) in people with IBD through a two-arm RCT. Methods: Participants were recruited at the Gastroenterology Department of the Coimbra University Hospital between June and September 2019. Of the 355 patients screened, those who accepted to participate were randomly assigned to one of two conditions: experimental group (LIFEwithIBD; n = 25) or control group (waitlist; n = 29). Participants completed self-report measures at baseline (T0), post-intervention (T1), and 3-month (T2) and 12-month (T3) follow-ups. Intervention acceptability was assessed. Efficacy was examined using intent-to-treat ANCOVA at post-intervention after adjusting for baseline values of depressive, anxiety, and stress symptoms (primary outcomes). Linear mixed models for all longitudinal outcomes were also analysed. Inflammatory and disease biomarkers were determined at T0 and T3. Results: Acceptability results revealed a high level of satisfaction and perceived usefulness regarding the intervention. Both groups experienced a significant decrease in stress symptoms and IBD symptom perception at T1. No significant differences were observed at follow-up for the primary outcomes. The experimental group reported significantly lower Crohn's disease Symptom severity at T2 than the control group. Post-hoc analyses designed to mitigate floor effects revealed substantial treatment effects for the experimental group regarding anxiety symptoms. No significant differences were observed in clinical biomarkers from T0 to T3. Conclusion: The LIFEwithIBD intervention shows promising, although preliminary, benefits for managing disease activity and reducing anxiety symptoms in IBD patients with high severity of psychological distress.Clinical trial registration: https://www.clinicaltrials.gov/ct2/show/NCT03840707, identifier NCT03840707.

The mannose receptor is expressed by olfactory ensheathing cells in the rat olfactory bulb.

Complex carbohydrate structures are essential molecules of infectious bacteria, parasites, and host cells and are involved in cell signaling associated with immune responses, glycoprotein homeostasis, and cell migration. The uptake of mannose-tailed glycans is usually carried out by professional phagocytes to trigger MHC class I- and MHC class II-restricted antigen presentation or, alternatively, to end inflammation. We have detected the mannose receptor (MR) in cultured olfactory ensheathing cells (OECs), so we investigated by flow cytometry whether recently dissociated cells of the olfactory bulb (OB) nerve fiber layer (ONL) could bind a mannosylated ligand (fluorescein conjugate of mannosyl bovine serum albumin; Man/BSA-FITC) in a specific manner. In addition, we estimated the relative proportion of ONL OECs, microglia, and astrocytes, tagged by 2'3'-cyclic nucleotide 3'-phosphodiesterase (CNPase), by the B4 isolectin of Griffonia simplicifonia (IB4), and by glial fibrillary acidic protein (GFAP), respectively, that were Man/BSA-FITC(+) . We also determined by histochemistry and/or immunohistochemistry whether Man/BSA-FITC or an anti-MR antibody (anti-C-terminal MR peptide; anti-cMR) labeled OECs and/or parenchymal microglia. In addition, we confirmed by Western blot with the K1K2 (against the entire MR molecule) antibody that a band of about 180 kDA is expressed in the OB. Our findings are compatible with a prospective sentinel role of OECs against pathogens of the upper airways and/or damage-associated glycidic patterns as well as with homeostasis of OB mannosylated glycoproteins.

Genealogical analysis of Quaternary Prevention: between the use of Evidence-Based Medicine and care reformulation in Primary Health Care. / Genealogia da Prevenção Quaternária: entre o uso da Medicina Baseada em Evidências e a reformulação do cuidado na Atenção Primária à Saúde.

We conducted a genealogical analysis of quaternary prevention, an instrument of primary health care to address overmedicalization and iatrogenesis, based on related statements and interviews with the creators of this concept. This tool has been used in the reformulation of care and the doctor-patient relationship, but limited to the risk-benefit assessment by using current scientific evidence. In this study, we analyze the paradoxes of evidence-based medicine (EBM) and discuss the relationship of EBM and quaternary prevention and primary health care (PHC). Finally, we suggest questioning the truth of the evidence for the development of other health paradigms.

Realizamos uma análise genealógica da Prevenção Quaternária, instrumento da Atenção Primária à Saúde de enfrentamento à medicalização e a iatrogenia, a partir de seus enunciados e de entrevistas com seus formuladores. Identificamos que a ferramenta tem sido tanto apresentada como uma reformulação do cuidado e da relação médico-paciente, como também reduzida ao cálculo do risco-benefício por meio da aplicação atualizada de evidências científicas. Analisamos os paradoxos da Medicina Baseada em Evidências e problematizamos sua relação com a Prevenção Quaternária e a Atenção Primária à Saúde. Por fim, sugerimos questionar a verdade das evidências para o desenvolvimento de outros paradigmas de saúde.

Corrigendum: Efficacy of an ACT and compassion-based ehealth program for self-management of chronic pain (iACTwithPain): study protocol for a randomized controlled trial.

[This corrects the article DOI: 10.3389/fpsyg.2021.630766.].