Further, OCD severity predicted EM with a medium to large effect size, suggesting that more symptomatic patients showed greater monitoring of their mistakes. Finally, group moderated the relationship between RI and EM with a small effect size. Our findings suggest that demographic factors may influence RI, whereas clinical factors may influence EM. Further, we found preliminary behavioral evidence to indicate that impaired RI and excessive EM are related in OCD.In a nationwide online survey of professional physiotherapists PT, the role of health literacy in the professional self-image of physiotherapists was investigated. The construct of health literacy was considered by PT to be important in working with patients. A lack of time resources was mentioned by the majority as an inhibiting factor with regard to dealing with the topic and its integration into everyday clinical practice. Specialist articles and further training courses on the subject of health literacy are necessary in addition to being anchored in training and studies in order to improve knowledge of health literacy and its relevance in the care of patients by PT.Background The frailty phenotype for older people is defined as an increased vulnerability to stressors, leading to adverse health outcomes. check details It is acknowledged as a specific precursor of disability besides chronic diseases that allows for some reversibility in the loss of autonomy. Although the literature on the socio-economic determinants of frailty is emerging in cross-sectional settings, little is known about the dynamics of this relationship over time. This article examines the joint evolution of frailty and change in economic conditions for the 65+ in Europe. Methods Individual and longitudinal data from SHARE (Survey on Health, Ageing and Retirement in Europe) over the period 2004-12 has been used. The sample contains 31 044 observations from 12 002 respondents aged 65 or more. A fixed effect Poisson model is estimated in order to control for unobserved individual heterogeneity. Three types of explanative economic variables have been considered in turn income, wealth and a subjective variable of deprivation. Results Our results indicate that individuals with worsening economic conditions (wealth and subjective deprivation) over time simultaneously experience a rapid increase in the frailty symptoms. Results also show that the nature of economic variable does not affect the frailty process in the same way. Subjective measure of deprivation seems to better evaluate the household’s financial difficulties than objective measure. Conclusion From a public policy perspective, these results show that policies fostering economic conditions of the elderly could have a significant impact on frailty and henceforth, could reduce the risks of disability.Introduction Well-being and quality of life (QoL) in the workplace have become a priority in all professions. Both academic studies and the media seek to assess how physicians feel. Nonetheless, few studies have focused on the specific situation of surgeons in terms of their work/life balance and their satisfaction at work. These observations led us to conduct a survey to describe these factors among gynecologic surgeons, as a function of their lifestyles and professional practices. Material and methods This self-administered cross-sectional survey was distributed by email to the gynecologic surgeons currently practicing in France, both those who do and do not continue to cover on-call obstetrics duty. This analysis compared responses by gender. Results Between February and June 2019, we collected 253 responses 105 from women and 148 from men. In all, 59.6% of the surgeons reported working from 50 to 75 h weekly, and 23.7% considered their workload very high and difficult to manage. Indeed, 32.4% reported therofessional satisfaction.A 14-year-old girl with cardiopulmonary arrest was referred to our hospital. She had received an injection of inactivated influenza vaccine 7 days before the referral. Her cardiac rhythm was pulseless wide QRS tachycardia, and mechanical circulatory support was immediately commenced. Results of endomyocardial biopsy showed that there was massive infiltration of CD3- and CD68-positive cells, and various degrees of cardiomyocyte necrosis in all of three endomyocardial specimens, while infiltration of eosinophils or giant cells was not observed. A histological diagnosis of lymphocytic myocarditis was made. Acute myocarditis is a rare but potentially fatal complication of the influenza vaccination.Purpose To develop a novel treatment planning process (TPP) with simultaneous optimization of modulated photon, electron and proton beams for improved treatment plan quality in radiotherapy. Methods A framework for fluence map optimization of Monte Carlo (MC) calculated beamlet dose distributions is developed to generate treatment plans consisting of photon, electron and spot scanning proton fields. Initially, in-house intensity modulated proton therapy (IMPT) plans are compared to proton plans created by a commercial treatment planning system (TPS). A Triple Beam radiotherapy (TriB-RT) plan is generated for an exemplary academic case and the dose contributions of the three particle types are investigated. To investigate the dosimetric potential, a TriB-RT plan is compared to an in-house IMPT plan for two clinically motivated cases. Benefits of TriB-RT for a fixed proton beam line with a single proton field are investigated. Results In-house optimized IMPT are of at least equal or better quality than TPS generated proton plans and MC-based optimization shows dosimetric advantages for inhomogeneous situations. Concerning TriB-RT, for the academic case, the resulting plan shows substantial contribution of all particle types. For the clinically motivated, improved sparing of organs at risk close to the target volume is achieved compared to IMPT (e.g. myelon and brainstem Dmax -37%) at cost of an increased low dose bath (healthy tissue V10 +22\%). In the scenario of a fixed proton beam line, TriB-RT plans are able to compensate the loss in degrees of freedom to substantially improve plan quality compared to a single field proton plan. Conclusion A novel TPP which simultaneously optimizes photon, electron and proton beams was successfully developed. TriB-RT shows the potential for improved treatment quality and is especially promising for cost-effective single-room proton solutions with a fixed beamline in combination with a conventional linac delivering photon and electron fields.