BACKGROUND & AIMS: :Intensive agricultural practices and current western consumption patterns are associated with increased ecological pressure. One way to reduce the ecological impact could be a shift to more sustainable food choices. This study investigates consumer opinions towards a series of food choices with a lower ecological impact. The investigated food choices range from well-known meat substitutes to alternatives which are more radical or innovative and that require an adaptation of food habits and cultural patterns. Results are obtained through a survey among 221 Flemish respondents in Spring 2011. Many consumers underestimate the ecological impact of animal production. Well-known alternatives such as organic meat, moderation of meat consumption and sustainable fish are accepted, although willingness to pay is clearly lower than willingness to consume. Consumers are more reluctant to alternatives that (partly) ban or replace meat in the meal. Opportunities of introducing insects currently appear to be non-existent. Five consumer segments were identified based on self-evaluated ecological footprint and personal relevance of the ecological footprint. The segments were termed Conscious, Active, Unwilling, Ignorant and Uncertain. A profile in terms of demographics, attitudinal and behavioral characteristics is developed for each segments, and conclusions with respect to opportunities for sustainable food choices are discussed.

背景与目标： : 集约化农业实践和当前的西方消费模式与生态压力增加有关。减少生态影响的一种方法可能是转向更可持续的食物选择。这项研究调查了消费者对一系列生态影响较低的食物选择的看法。所调查的食物选择范围从著名的肉类替代品到更激进或创新的替代品，需要适应饮食习惯和文化模式。结果是通过对2011年春季的221名佛兰德受访者的调查获得的。许多消费者低估了动物生产对生态的影响。众所周知的替代品，例如有机肉，适度的肉类消费和可持续的鱼类被接受，尽管支付意愿明显低于消费意愿。消费者更不愿选择 (部分) 禁止或替换餐食中的肉类的替代品。目前似乎不存在引入昆虫的机会。根据自我评估的生态足迹和生态足迹的个人相关性，确定了五个消费者细分市场。这些部分被称为有意识的，积极的，不愿意的，无知的和不确定的。针对每个细分市场制定了人口统计，态度和行为特征的概况，并讨论了有关可持续食物选择机会的结论。

BACKGROUND & AIMS: :Periacetabular osteotomy (PAO) is a well established method to treat hip dysplasia in the adult. There is, however, a lack of information on the subjective outcome of patients with complications after PAO. The purpose of this study was therefore to assess the influence of complications on the patients' post-operative wellbeing and function: 60 PAOs on 50 patients were investigated retrospectively after a mean follow-up of 7.4 years. The patients' self-reported assessment of health and function was evaluated by the Medical Outcomes Short Form-36 (SF-36) and the Western Ontario and McMaster Universities (WOMAC) questionnaires at last follow-up. Forty healthy persons served as a control group. Of the 60 interventions 13 had no complications. Minor complications occurred in 25 (41%) and in 22 (37%) at least one major complication occurred. SF-36 summary measure was 76.4 for PAO patients and 90.3 for the control group. Mean WOMAC score was 25.1. Patients with major complications had a similar subjective outcome as patients with minor or without complications, but persistent dysaesthesia due to lateral femoral cutaneous nerve dysfunction led to a worse subjective function. Lesions of the lateral femoral cutaneous nerve have much greater influence on patients' self-assessed functional outcome after PAO than previously reported and greater attention has to be given to this supposedly minor complication.

背景与目标： : 髋臼周围截骨术 (PAO) 是治疗成人髋关节发育不良的公认方法。但是，缺乏有关PAO术后并发症患者的主观结果的信息。因此，本研究的目的是评估并发症对患者术后健康和功能的影响: 平均随访7.4年后，对50例患者的60个pao进行了回顾性调查。在最后的随访中，通过医疗结果简表36 (SF-36) 以及西安大略和麦克马斯特大学 (WOMAC) 问卷对患者的自我报告的健康和功能评估进行了评估。40名健康人作为对照组。在60种干预措施中，有13种没有并发症。轻微并发症发生在25 (41%) 和22 (37%) 中，至少发生了一种主要并发症。PAO患者的SF-36总结措施为76.4，对照组为90.3。平均WOMAC得分为25.1。有重大并发症的患者的主观结局与有轻微或没有并发症的患者相似，但是由于股外侧皮肤神经功能障碍而导致的持续感觉障碍导致主观功能恶化。PAO术后股外侧皮神经病变对患者自我评估功能结果的影响比以前报道的要大得多，因此必须对这种所谓的轻微并发症给予更多关注。

BACKGROUND & AIMS: BACKGROUND:Patient satisfaction, one of the main components of quality of care, is a crucial phenomenon for the overall health care delivery system. Even though a number of studies have been conducted about patient satisfaction in different health services, studies in radiology services are flimsy in Ethiopia. This study aimed at assessing patient satisfaction towards radiological service and associated factors in Hawassa University Teaching and Referral hospital. METHODS:An institution based cross-sectional study was conducted among 321 adult patients presented for radiological service in the study area using stratified sampling technique. Patient satisfaction was measured using SERVQUAL (Service Quality) tool that consisted of seven items: accessibility, quality of radiological service, courtesy of radiology staff, existence of good communication with service provider and desk worker, physical environment and privacy technique. Exit interviews of patients were conducted using a structured and pretested questionnaire. Data was collected by three grade ten completed trained data collectors from May 12 to May 28, 2016. Multiple logistic regressions were used to identify independent factors associated with patient satisfaction on radiological services using SPSS version 21. RESULTS:The overall patient satisfaction towards radiological service was 71.6%. Satisfaction to accessibility of the service was 84.5% while it was 80.6% to courtesy of the staff. Similarly, 81.6% reported satisfied with quality of the service and 59.4% and 71% of reported satisfied with physical environment and radiological service provider respectively. On the other hand, 99.7% of the respondents were dissatisfied with privacy of the service. The study revealed that patients who attended primary school (AOR = 0.317, 95% CI: 0.11-0.88), unemployed patients (AOR = 0.067, 95% CI: 0.007-0.622) and patients who had short waiting time to enter into examination room less than one hour (AOR = 4.12, 95% CI: 1.4-11.62) were factors associated with patients satisfaction. CONCLUSION:This study found that majority of respondents was satisfied with the radiological services. Respondent's education level, occupation as well as duration of time taken to enter into examination room were important factors influencing the satisfaction condition. Hence, concerted effort is needed to constantly improve on patient satisfaction to better radiology returns arising from improved patient patronage. It is recommended to give great care and attention to clients during radiological examination procedure and also suggested that the department should decrease time taken to enter into examination room. On the other hand, the reasons behind more educated clients were less satisfied with radiologic service than more educated respondents need further investigation.

背景与目标：

BACKGROUND & AIMS: BACKGROUND:The reasons for low adherence to cereal dietary guidelines are not well understood but may be related to knowledge, attitudes, beliefs and perceived barriers. This study aims to assess trends in cereal foods consumption, intention to change and factors associated with intake among Western Australian (WA) adults 18 to 64 years. METHOD:Cross-sectional data from the 1995, 1998, 2001, 2004, 2009, and 2012 Nutrition Monitoring Survey Series involving 7044 adults were pooled. OUTCOME VARIABLES:types and amount of cereals (bread, rice, pasta, and breakfast cereal) eaten the day prior. Attitudes, knowledge, intentions, weight status and sociodemographic characteristics were measured. Descriptive statistics, multiple binary logistic and multinomial logistic regressions assess factors associated with consumption. RESULTS:Bread (78%) was the most commonly consumed cereal food. The proportion eating bread decreased across survey years (Odds Ratio OR = 0.31; 95% Confidence Interval; 0.24-0.40 in 2012 versus 1995), as did the amount (4.1 slices of bread in 1995 to 2.4 in 2012). The odds of consuming whole-grain cereal foods increased since 2009 (OR = 1.27; 1.02-1.58 versus 1995 p < 0.05). The likelihood of trying to eat less cereal food in the past year was greater in 2012 compared to 1995 (Relative Risk Ratio RRR 10.88; 6.81-17.4). Knowledge of cereal recommendations decreased over time (OR = 0.20; 0.15-0.27 in 2012 versus 1995 p < 0.001). Overweight and obese respondents were more likely than healthy weight respondents to have tried to eat less cereals (RRR 1.65; 1.22-2.24 and 1.88; 1.35-2.63 respectively). 'I already eat enough' was the main barrier (75% in 1995 to 84% in 2012 (p < 0.001)). CONCLUSIONS:WA adults are actively reducing the amount of cereal foods they eat and intake is associated with a misperception of adequacy of intake. Nutrition intervention is needed to increase awareness of the health benefits of cereal foods, particularly whole-grains, and to address barriers to incorporating them daily. TRIAL REGISTRATION:Not applicable.

背景与目标：

BACKGROUND & AIMS: BACKGROUND:To analyse the psychometric properties of the structured Satisfaction Questionnaire with Gastrostomy Feeding (SAGA-8) in parents/caregivers of children with home enteral nutrition (HEN) by gastrostomy tube (GT). METHODS:Eighty-six caregivers (mothers) of paediatric patients with HEN by GT were recruited. Patients suffered from neurological disease (61.6%) and other chronic diseases. The SAGA-8 scale, a structured questionnaire to explore satisfaction with HEN by GT, and the Caregiver Burden Inventory (Zarit) were completed. The discriminating power of each of the SAGA-8 items, internal consistency and external validity were evaluated. An exploratory factor analysis and Kaiser-Meyer-Olkin (KMO) was performed as well. RESULTS:Eighty-four percent of the families expressed high satisfaction with GT feeding. All eight items of SAGA-8 gave additional information. The exploratory factor analysis revealed that a significant part of the items' variability could be explained by two independent factors: Factor 1 (direct benefit), which compiled the variables related to the perception of children's overall improvement by GT feeding; Factor 2 (indirect benefit), which grouped the variables related to a decrease in respiratory infections, feeding time and institutional support. Results from KMO (0.628) indicated the high adequacy of the items assessed in the factorial analysis. Moreover, the questionnaire presented high internal consistency (0.76), and the external validation analysis confirmed the correlation between SAGA-8 and Zarit, thereby emphasising the approptiate use of the SAGA-8 to detect carers' satisfaction. CONCLUSIONS:The SAGA-8 questionnaire has a high discriminatory power to assess the degree of satisfaction experienced by parents/caregivers of children with HEN by GT and, subsequently, the patients' wellbeing.

背景与目标：

BACKGROUND & AIMS: STUDY QUESTION:What was the impact on access to assisted reproductive technology (ART) treatment by different socioeconomic status (SES) groups after the introduction of a policy that increased patient out-of-pocket costs? SUMMARY ANSWER:After the introduction of a policy that increased out-of-pocket costs in Australia, all SES groups experienced a similar percentage reduction in fresh ART cycles per 1000 women of reproductive age. Higher SES groups experienced a progressively greater reduction in absolute numbers of fresh ART cycles due to existing higher levels of utilization. WHAT IS KNOWN ALREADY:Australia has supportive public funding arrangements for ARTs. Policies that substantially increase out-of-pocket costs for ART treatment create financial barriers to access and an overall reduction in utilization. Data from the USA suggests that disparities exist in access to ART treatment based on ethnicity, education level and income. STUDY DESIGN, SIZE, DURATION:Time series analysis of utilization of ART, intrauterine insemination (IUI) and clomiphene citrate by women from varying SES groups before and after the introduction of a change in the level of public funding for ART. PARTICIPANTS/MATERIALS, SETTING, METHODS:Women undertaking fertility treatment in Australia between 2007 and 2010. MAIN RESULTS AND THE ROLE OF CHANCE:Women from higher SES quintiles use more ART treatment than those in lower SES quintiles, which likely reflects a greater ability to pay for treatment and a greater need for ART treatment as indicated by the trend to later childbearing. In 2009, 10.13 and 5.17 fresh ART cycles per 1000 women of reproductive age were performed in women in the highest and lowest SES quintiles respectively. In the 12 months after the introduction of a policy that increased out-of-pocket costs from ∼$1500 Australian dollars (€1000) to ∼$2500 (€1670) for a fresh IVF cycle, there was a 21-25% reduction in fresh ART cycles across all SES quintiles. The absolute reduction in fresh ART cycles in the highest SES quintile was double that in the lowest SES quintile. LIMITATIONS, REASONS FOR CAUTION:In this study, SES was based on the average relative socioeconomic advantage and disadvantage of small geographic areas, and therefore may not reflect the SES of an individual. Additionally, the policy impact was limited to the 12 months following its introduction, and may not reflect longer term trends in ART treatment. WIDER IMPLICATIONS OF THE FINDINGS:While financial barriers are an important obstacle to equitable access to ARTs, socioeconomic differences in utilization are likely to persist in countries with supportive public funding, due in part to differences in childbearing patterns and treatment seeking behaviour. Policy makers should be informed of the impact that changes in the level of cost subsidization have on access to ART treatment by different socioeconomic groups. STUDY FUNDING/COMPETING INTEREST(S):G.M.C. receives grant support to her institution from the Australian Government, Australian Research Council (ARC) Linkage Grant No LP1002165; ARC Linkage Grant Partner Organisations are IVFAustralia, Melbourne IVF and Queensland Fertility Group. V.P.H. is employed as an Economics Research Associate on the same grant. P.J.I. is Medical Director of the IVF Clinic, IVFAustralia and has a financial interest in the parent group, Virtus. TRIAL REGISTRATION NUMBER:N/A.

背景与目标：

BACKGROUND & AIMS: :Treating migraine attacks early with triptans may be more effective than late triptan administration. However, in published studies, the definition of 'early' varied (in terms of time, pain intensity or presence of allodynia) or was unclear. Therefore, clear clinical indications have not been established. Appropriately designed trials to address this issue remain a priority. Early triptan treatment may also have disadvantages, including inadvertent treatment of tension-type headaches and danger of medication overuse. At present, only those migraineurs with rapid pain worsening, high pain recurrence rate and clinical indications of allodynia should be encouraged to take triptans as quickly as possible. This recommendation implies a requirement for patient education and the need to carefully tailor treatment to individual needs.

背景与目标： : 早期用曲坦治疗偏头痛发作可能比晚期服用曲坦更有效。然而，在已发表的研究中，“早期” 的定义有所不同 (在时间，疼痛强度或异常性疼痛的存在方面) 或不清楚。因此，尚未建立明确的临床适应症。解决这一问题的适当设计的试验仍然是一个优先事项。早期曲坦治疗也可能有缺点，包括无意中治疗紧张型头痛和药物过度使用的危险。目前，只有那些疼痛迅速恶化，疼痛复发率高且有异常性疼痛的临床指征的偏头痛患者才应鼓励尽快服用曲普坦斯。此建议意味着需要对患者进行教育，并且需要根据个人需求精心定制治疗方法。

BACKGROUND & AIMS: INTRODUCTION:Many types of catheters are available in market for clean intermittent catheterization (CIC). Each company claim superiority of their products, but strong evidence is lacking. PURPOSE:To assess the complications due to CIC in spina bifida children and its possible relationship to hydrophilic-coated catheter (HCC) or uncoated catheters (UCCs), with a view to decrease catheter related complications, and improve patients experience and compliance. MATERIALS AND METHODS:The authors retrospectively reviewed the spina bifida patients aged between 0 and 16 years, who had no surgical intervention, and were performing CIC urethrally for at least 6 months. General information was recorded from electronic patient record, followed by telephonic/outpatient interview. Patients were divided into two groups: UCC or HCC. Patients in both groups had also used catheter from the other group at times. This study recorded the type/size of catheter used, its duration, complications, and their possible relation to type of catheter. Carer/patients overall satisfaction was recorded on a scale of 1-10 and their preference about the type of catheter they wish. The data were analyzed using SPSS (P-value < 0.05 as significant). RESULTS:One hundred one patients were included in the study: 53 UCC and 48 HCC. There was no significant difference between gender/associated conditions/age at start of CIC or duration of CIC. The mean time taken to perform the procedure was similar in both groups: UCC 9.7 min vs HCC 8.8 min. Difficulty in insertion was felt in 20, UCC 12 vs HCC 8 (P = 0.15), recurrent UTIs UCC 12 vs HCC 17 (P = 0.09), median patient satisfaction UCC 8/10 (3-10) and HCC 10/10 (7-10) (P = 0.63). Request for change of catheter was made by 10 from UCC group to HCC vs none from HCC (P ≤ 0.05).When given a choice, 28/53 (52.8%) in UCC and none (0%) in HCC group (P ≤ 0.0001) preferred to change to the other type of catheter, mainly for convenience of use of the product. Per year per patient cost was UCC US$ 389 vs HCC US$ 2820. DISCUSSION:Many un-modifiable factors contribute to the outcome of CIC. Despite claims of superiority by manufactures of some catheters over others, strong evidence is lacking especially in children. This study has shown no difference in the complications between UCC and HCC. CONCLUSION:There is no significant difference in complication rates with urethral CIC in patients using either UCC or HCC. A significant majority would prefer to use HCC mainly because of convenience of use of the product though at a seven times higher cost.

背景与目标：

BACKGROUND & AIMS: BACKGROUND:It can be difficult to engage consumers in health decision making. This is particularly so in the area of palliative care, where consumers are very unwell and are unlikely to become involved in long-term programmes that promote consumer input. This paper explores the possibility of using 'Consumer Impact Statements' to facilitate the inclusion of the viewpoint of people at the end of life in the process of policy and decision making, particularly in the area of subsidy of pharmaceuticals used in palliative care. SEARCH STRATEGY:A broad search was conducted to find information about the use of impact statements in any health field. The health literature and grey literature were searched to explore the use of Consumer Impact Statements to date. RESULTS:No papers were found describing the use of Consumer Impact Statements in the palliative care setting. Health impact assessment is used in the areas of environmental health and community health. Impact statements are less commonly used in other areas of health, especially policy development, and no formal description of a Consumer Impact Statement was found. DISCUSSION:There is considerable scope for developing the use of Consumer Impact Statements to promote the consumer viewpoint in health decision making, because it will allow people who are otherwise unlikely to contribute to the public debate to have their views heard by decision makers. CONCLUSION:The use of Consumer Impact Statements is particularly suited to palliative care, given that consumers are often otherwise unable to contribute to the public debate.

背景与目标：

BACKGROUND & AIMS: PURPOSE:The purpose of this study was twofold: (a) to assess predictors of the turnover intention, burnout, and perceived quality of care among nurses working in Oman, and (b) to examine the potential moderating role of job satisfaction on the relationship between work environment and nurse turnover intention. DESIGN:A cross-sectional design was used to collect data from a sample of 207 nurses working in a public hospital in Muscat, Oman. METHODS:An electronic survey was used to assess nurses' perceptions of work environment, burnout, job satisfaction, turnover intention, and quality of care. FINDINGS:Participation in hospital affairs, a foundation for quality of care, and staffing adequacy were predictors of burnout among nurses and perceived quality of care. Logistic regression analysis revealed that working in a favorable environment was associated with less turnover intention, but only when job satisfaction was high. CONCLUSIONS:Improving nurse job satisfaction is a mechanism through which future interventions could enhance working conditions and promote better nurse retention. CLINICAL RELEVANCE:Organizational strategies are needed to increase nurse job satisfaction by empowering nurses to take more active roles in hospital affairs as a strategy to reduce turnover intention and enhance the quality of patient care.

背景与目标：

BACKGROUND & AIMS: BACKGROUND:Split thickness skin grafting (SSG) is an important modality for wound coverage; however, it leads to donor site morbidity. Epidermal grafting (EG) is a promising option for autologous skin grafting which offers minimal donor site morbidity, though it is not known if EG is an effective clinical alternative for SSG. This study compared the efficacy of EG as an alternative to SSG in terms of wound healing outcomes, donor site morbidity, patient satisfaction and adverse events. METHODS:EPIGRAAFT is a Phase 2, randomized, open-label trial with two parallel groups: EG and SSG. Patients referred for skin grafting with a healthy granulating wound bed were included. The co-primary endpoints were the proportion of wounds healed and donor site healing time. The secondary endpoints include donor site morbidity measured using Vancouver Scar Scale, mean time for complete wound healing, patient satisfaction assessed using a validated skin grafting questionnaire and incidence of adverse events. RESULTS:Of the 61 patients screened, 44 patients were randomized. There was no difference in the proportion of wounds healed at 6 weeks (p=0.366) and 3 months(p=0.24) as well as the mean time for wound healing (p=0.12). EG resulted in lower donor site morbidity (p=0.001), faster donor site healing time (EG: 4.86 days vs. SSG: 21.32 days) (p<0.0001), and higher overall satisfaction (p<0.001). There were no adverse events reported. CONCLUSION:This study demonstrated that EG has superior donor site outcomes with faster donor site healing and lower morbidity compared to SSG, while having comparable wound healing outcomes. Patients receiving EG also experienced higher donor site satisfaction compared to SSG. ClinicalTrials.gov identifier: NCT02535481.

背景与目标：

BACKGROUND & AIMS: BACKGROUND:In the United States, emergency medicine clinical pharmacists have become more common over the last several decades. Despite being a vital component of the emergency department interdisciplinary team, there is very limited information published regarding the direct impact emergency medicine clinical pharmacists have on other emergency department-based professions. OBJECTIVE:To determine if the addition of an emergency medicine clinical pharmacist improves nursing satisfaction with pharmacy services. SETTING:The study was conducted at a 422-bed urban teaching hospital consisting of approximately 60 emergency medicine nurses. METHODS:This was a prospective study that evaluated nursing satisfaction prior to the initiation of an emergency medicine clinical pharmacist and one year after implementation. The survey consisted of 29 questions and was designed to assess three areas of pharmacy: general pharmacy, pharmacy information technology, and emergency medicine clinical pharmacy services. For the majority of questions, a 5-point Likert scale ranging from 1 representing strongly disagree to 5 representing strongly agree was utilized. Responses for the 5 point Likert scale were further tabulated into either positive or negative responses. All emergency department nurses employed during the study period (September 2015 and 2016) were eligible to participate anonymously. MAIN OUTCOME MEASURE:The main outcome assessed was the difference in satisfaction scores between study periods. RESULTS:A total of 52 surveys were returned over the course of the study (22 [36.7%] in the pre-intervention group versus 30 [50%] in the post-intervention group). All general pharmacy questions were improved at one year with timely resolution of pharmacy related issues, medication procurement, and satisfaction with pharmacy services achieving statistical significance. Pharmacy information technology questions were significantly improved with respect to satisfaction with the automated medication dispensing system inventory, prevention and resolution of medication stock outs, and ease of medication removal compared to baseline. The perceived impact of emergency medicine clinical pharmacy services in the pre-intervention group was validated after the one-year implementation period. CONCLUSION:An emergency medicine clinical pharmacist increases nursing satisfaction with central pharmacy and pharmacy technology services and was able to maintain the nurses' perceived expected role of the clinical pharmacist.

背景与目标：

BACKGROUND & AIMS: BACKGROUND:The Mediterranean diet is one of the healthier diet models. Mediterranean food patterns are suffering a deterioration that can especially affect children and adolescents. OBJECTIVE:Determine adherence to the Mediterranean diet in adolescents of southern Spain and its relationship with the residence area, sex, age, life satisfaction, anthropometry, and habits of physical activity and sedentary activities. METHODOLOGY:A total of 1973 adolescents (11-18 years) of southern Spain participated in this descriptive cross-sectional study. Cut-off value between rural and urban locations was 10000 inhabitants. Adherence to the Mediterranean diet was calculated from the KIDMED questionnaire. Life satisfaction, physical activity, and sedentary activities also were measured through valid and reliable questionnaires. Body mass index and % body fat were measured using the TANITA BC-420-S body analyzer. RESULTS:30.9% of the adolescents reported an optimal quality diet, percent higher in rural locations (P < 0.05). Adherence was lower in older adolescents (P < 0.001), it was not different between sexes or according to anthropometric variables. Adolescents more satisfied with their lives (P < 0.001), more active (P < 0.001), more studious (P < 0.001), and less sedentary in front of a screen (P < 0.001) showed greater adherence to the Mediterranean food pattern. CONCLUSION:The majority of adolescents need to improve their nutritional quality. Compared with these subjects, the adolescents most adherent to the Mediterranean diet had a healthier lifestyle and they showed greater life satisfaction. :Introducción: La dieta mediterránea es uno de los modelos más saludables de dieta. Los patrones alimentarios mediterráneos están sufriendo un deterioro que puede afectar especialmente a niños y adolescentes. Objetivo: Determinar la adherencia a la dieta mediterránea de los adolescentes del sur de España y su relación con el área de residencia, sexo, edad, satisfacción con la vida, características antropométricas y hábitos de actividad física y sedentaria. Métodos: Un total de 1.973 adolescentes (11-18 años) del sur de España participaron en este estudio descriptivo transversal. El punto de corte entre poblaciones rurales y urbanas fue 10.000 habitantes. La adherencia a la dieta mediterránea fue calculada a partir del cuestionario KIDMED. Satisfacción con la vida, actividad física y sedentarismo también mediante cuestionarios fiables y válidos. Índice de masa corporal y % de grasa corporal fueron medidos utilizando el analizador corporal TANITA BC-420-S. Resultados: El 30,9% de los adolescentes reportó una dieta de calidad óptima, porcentaje superior en poblaciones rurales (P < 0,05). La adherencia fue menor en los adolescentes de mayor edad (P < 0,001), sin diferir entre sexos ni según las variables antropométricas. Los adolescentes más satisfechos con sus vidas (P < 0,001), más activos (P < 0,001), más estudiosos (P < 0,001) y menos sedentarios delante de una pantalla (P < 0,001) mostraron mayor adherencia al patrón alimentario mediterráneo. Conclusión: La mayoría de adolescentes necesitan mejorar su calidad nutricional. En comparación con estos sujetos, los más adheridos a la dieta mediterránea llevaban un estilo de vida más saludable y mostraron mayor satisfacción con sus vidas.

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BACKGROUND & AIMS: IMPORTANCE:The value of direct-to-consumer advertising (DTCA) of prescription drugs is widely debated, as is the effect of DTCA on prescription sales and health care utilization. OBJECTIVE:We examined the association between DTCA intensity for statin medications and prescription sales and cholesterol-related health care utilization. DESIGN, SETTING, AND PARTICIPANTS:We conducted an ecological study for 75 designated market areas from 2005 to 2009 in the United States using linked data regarding televised DTCA volume, non-DTCA marketing and promotion, retail, mail order and long-term care prescription drug sales, prescription drug and ambulatory care health care utilization, and contextual factors such as health care density and socioeconomic status. Main outcomes and measures were volume of sales, number of dispensed prescriptions, and high cholesterol-related outpatient visits. Analyses were conducted in 2016. RESULTS:The intensity of rosuvastatin and atorvastatin ad exposures per household varied substantially across designated market areas. After adjustment for socioeconomic, demographic, and clinical characteristics, each 100-unit increase in advertisement viewership was associated with a 2.22% [95% confidence interval (CI), 0.30%-4.19%] increase in statin sales. Similar patterns were observed between DTCA and statin dispensing among the commercially insured. DTCA was associated with increases in high cholesterol-related outpatient visits among adults 18-45 years of age (3.15% increase in visits per 100-unit increase in viewership, 95% CI, 0.98%-5.37%) but not among those 46-65 years of age (0.51%, 95% CI, -1.49% to 2.55%). CONCLUSION:DTCA for statins is associated with increases in statin utilization and hyperlipidemia-related outpatient visits, especially for young adults.

背景与目标：

BACKGROUND & AIMS: :Research has disregarded the boundary conditions of the effects of post-traumatic stress symptoms (PTSS) at work. Addressing this issue, the present study examines the moderating impact of the (shared vs. isolated) exposure to robbery on the relationship between PTSS and employee job satisfaction. Drawing on the conservation of resources theory, we argue that PTSS would positively affect employee job satisfaction when the robbery is experienced collectively. To test our predictions, we conducted a two-wave study-with a lag of two months between measurements-on 140 employees from a national bank in Italy. Results from hierarchical regression analyses supported our prediction: the exposure to robbery moderated the relationship between PTSS and job satisfaction. While within the "isolated exposure" group the job satisfaction score was higher among less symptomatic victims, within the "shared exposure" group those with high PTSS reported higher job satisfaction levels than those with low PTSS. We discuss the implications of these findings for theory and practice.

背景与目标： : 研究忽略了创伤后应激症状 (PTSS) 在工作中的影响的边界条件。针对这一问题，本研究探讨了抢劫 (共享与孤立) 暴露对PTSS与员工工作满意度之间关系的调节影响。根据资源守恒理论，我们认为，当集体经历抢劫时，PTSS会对员工的工作满意度产生积极影响。为了检验我们的预测，我们对意大利一家国家银行的140名员工进行了两波研究-两次测量之间间隔了两个月。分层回归分析的结果支持了我们的预测: 抢劫的暴露减轻了PTSS与工作满意度之间的关系。在 “孤立暴露” 组中，症状较少的受害者的工作满意度得分较高，而在 “共享暴露” 组中，具有高PTSS的人报告的工作满意度水平高于具有低PTSS的人。我们讨论了这些发现对理论和实践的影响。