The upsurge in the number of people affected by the COVID-19 is likely to lead to increased rates of emotional trauma and mental illnesses. This article systematically reviewed the available data on the benefits of interventions to reduce adverse mental health sequelae of infectious disease outbreaks, and to offer guidance for mental health service responses to infectious disease pandemic. PubMed, Web of Science, Embase, PsycINFO, WHO Global Research Database on infectious disease, and the preprint server medRxiv were searched. Of 4278 reports identified, 32 were included in this review. Most articles of psychological interventions were implemented to address the impact of COVID-19 pandemic, followed by Ebola, SARS, and MERS for multiple vulnerable populations. Increasing mental health literacy of the public is vital to prevent the mental health crisis under the COVID-19 pandemic. Group-based cognitive behavioral therapy, psychological first aid, community-based psychosocial arts program, and other culturally adapted interventions were reported as being effective against the mental health impacts of COVID-19, Ebola, and SARS. Culturally-adapted, cost-effective, and accessible strategies integrated into the public health emergency response and established medical systems at the local and national levels are likely to be an effective option to enhance mental health response capacity for the current and for future infectious disease outbreaks. Tele-mental healthcare services were key central components of stepped care for both infectious disease outbreak management and routine support; however, the usefulness and limitations of remote health delivery should also be recognized.

Gastric bypass surgery (GB) is a successful treatment for obesity(1). Following the procedure, patients report changes in preference away from palatable high fat (HF), high sugar (HS) foods that may contribute to weight loss(2). The aim of this work is to examine the relationship between changes in reported ‘liking’ (hedonic) and ‘wanting’(motivation) for HF, HS food and 24hr dietary intake post-GB. 15 GB patients (BMI: 41.7 ± 11.54kg/m2, 73% female) and 15 time-matched controls (BMI: 25.08 ± 4.37 kg/m2, 73% female) were recruited as part of a larger residential study and observed for 3 days at each of 3 time points; 1-month pre-surgery, 3-months post-surgery and 1 yr post-surgery. Covert, objective assessment of 24hr dietary intake was on day 2 of each visit using weighed food records. Participants had ad-libitum access to foods pre-determined by food preference questionnaires and proportionally represented by 6 macronutrient groups (HF/HS, HF/high CHO, HF/high protein, low fat/HS, low fat/high CHO, low fat/high protein). ‘Liking’ and ‘wanting’ was measured using the Leeds Food Preference Questionnaire (LFPQ)(3), a validated measure that uses visual analogue scales to determine explicit liking and wanting for food. Implicit preferences are determined using response and reaction time in a forced-choice task. GB patients significantly reduced their overall energy intake (EI) from baseline to three months (-6.9 ± 8.1MJ/d p = > 0.001) and 1 yr post-surgery (-5.3 ± 7.5MJ/d, p = 0.01) compared to controls. At 3mths post-GB, there was no significant relationship between changes in preference for HS food and changes in %EI from sugar (R2 = 0.97, F(3,26) = 0.94 p = 0.44) or from HS foods (R2 = 0.87, F(3,26) = 0.83, p = 0.49). Changes in preferences for HF food at 3mths post-surgery were not significantly related to %EI from fat (R2 = 0.16, F(3,26) = 1.66, p = 0.2) or HF food (R2 = 0.18, F(3,26) = 0.16, p = 0.93). These associations remained at 1 yr post-surgery. In conclusion, previous observations based on self-reported food intake have found changes in preference for HF, HS food that may contribute to weight loss in GB. In contrast, our results show no significant relationship between changes in preference and changes in dietary intake post-surgery. Further research using direct, objective measures of dietary intake is needed to elucidate further changes in dietary intake post-GB.

Introduction: Emergency department (ED) syncope management is extremely variable. We developed practice recommendations based on the validated Canadian Syncope Risk Score (CSRS) and outpatient cardiac monitoring strategy with physician input. Methods: We used a 2-step approach. Step-1: We pooled data from the derivation and validation prospective cohort studies (with adequate sample size) conducted at 11 Canadian sites (Sep 2010 to Apr 2018). Adults with syncope were enrolled excluding those with serious outcome identified during index ED evaluation. 30-day adjudicated serious outcomes were arrhythmic (arrhythmias, unknown cause of death) and non-arrhythmic (MI, structural heart disease, pulmonary embolism, hemorrhage)]. We compared the serious outcome proportion among risk categories using Cochran-Armitage test. Step-2: We conducted semi-structured interviews using observed risk to develop and refine the recommendations. We used purposive sampling of physicians involved in syncope care at 8 sites from Jun-Dec 2019 until theme saturation was reached. Two independent raters coded interviews using an inductive approach to identify themes; discrepancies were resolved by consensus. Results: Of the 8176 patients (mean age 54, 55% female), 293 (3.6%; 95%CI 3.2-4.0%) experienced 30-day serious outcomes; 0.4% deaths, 2.5% arrhythmic, 1.1% non-arrhythmic outcomes. The serious outcome proportion significantly increased from low to high-risk categories (p < 0.001; overall 0.6% to 27.7%; arrhythmic 0.2% to 17.3%; non-arrhythmic 0.4% to 5.9% respectively). C-statistic was 0.88 (95%CI0.86–0.90). Non-arrhythmia risk per day for the first 2 days was 0.5% for medium-risk, 2% for high-risk and very low thereafter. We recruited 31 physicians (14 ED, 7 cardiologists, 10 hospitalists/internists). 80% of physicians agreed that low risk patients can be discharged without specific follow-up with inconsistencies around length of ED observation. For cardiac monitoring of medium and high-risk, 64% indicated that they don't have access; 56% currently admit high-risk patients and an additional 20% agreed to this recommendation. A deeper exploration led to following refinement: discharge without specific follow-up for low-risk, a shared decision approach for medium-risk and short course of hospitalization for high-risk patients. Conclusion: The recommendations were developed (with online calculator) based on in-depth feedback from key stakeholders to improve uptake during implementation.

Drawing upon two independent samples from mainland China, we propose and investigate the deterrence function of leadership behavior focused on control. We suggest that controlling leadership, specifically, authoritarian leadership, deters employees’ deviance under certain conditions. That is, authoritarian leadership thwarts employees’ interpersonal deviance behavior when leaders send clear signals of potential punishments of non-compliance by showing low leader benevolence, and when employees are highly dependent on the leaders for important work resources. Results from two independent studies largely support our key propositions. Overall, these results add to the range of possible impacts that a leader can play in decreasing employee deviance. Theoretical implications and directions for follow-up research are discussed.

Hookworms represent a major infectious burden globally, especially in developing countries. The murine hookworm Nippostrongylus brasiliensis is normally cleared in a manner dependent on IL-13, IL4-R and STAT6 signalling. Here we have used STAT6-deficient animals to model a non-resistant population and describe 2 novel STAT6-independent processes for the clearance of N. brasiliensis. During primary infection STAT6−/− animals are able to clear gut-dwelling N. brasiliensis by a mechanism involving the trapping and degradation of worms in the gut mucosa. Here, a previously undescribed STAT6-independent up-regulation of Relm-β was observed which correlated with the mucosal trapping and degradation of worms. Previous studies have indicated that during secondary infection STAT6 deficient animals fail to expel adult worms and remain susceptible to re-infection and long-term colonization of the gut. We report here that an initial partially protective response occurs early upon re-infection in the absence of STAT6, and that a late-phase protective secondary response arises in the gut of STAT6-deficient mice leading to the clearance of the majority of N. brasiliensis, through their trapping and death in the mucosal layer of the lower region of the small intestine. These findings show that there are a number of redundant effector pathways which act to reduce worm burden in the gut which can be activated by mechanisms that do not work through the dominant STAT6 signalling pathway and may be useful as targets for future vaccination strategies against resistant hookworm strains.