In recent years, the nudge approach to behavior change has emerged from the behavioral sciences to challenge the traditional use of regulation in public health strategies to address modifiable individual-level behaviors related to the rise of noncommunicable diseases and their treatment. However, integration and testing of the nudge approach as part of more comprehensive public health strategies aimed at making healthy choices easier are being threatened by inadequate understandings of its scientific character, its relationship with regulation, and its ethical implications. This article reviews this character and its ethical implication with a special emphasis on the compatibility of nudging with traditional regulation, special domains of experience, and the need for a more nuanced approach to the ethical debate. The aim is to advance readers' understanding and give guidance to those who have considered working with or incorporating the nudge approach into programs or policies aimed at making healthful choices easier.
More and more people eat out and, therefore, foodservice business has an increasing influence on people's dietary intake. Foodservice business should, first and foremost, deliver a nice tasting meal of high quality-but health should not be neglected. Nudging and choice architecture is a field of foodservice business research that is gaining interest and this article offers original research in this field.
Introduction Acromioclavicular(AC) joint dislocations are common injuries, but the need for surgery is debated. The objective of the study was to evaluate the result after acute Rockwood type III and V AC joint dislocations managed nonsurgically with the option of delayed surgical intervention. Materials and Methods This was a prospective cohort study with clinical, radiological and patient-reported outcome assessment at baseline and 6w, 3m, 6m and 1y after acute AC joint dislocation. Inclusion criteria were patients aged 18-60 with acute AC joint dislocation and >50% superior displacement of the clavicle. All patients were treated non-surgically with 3 months of home-based training and with the option of delayed surgical intervention. At baseline, patients were graded as Rockwood type III or V based on the coracoclavicular difference. The primary outcome was the Western Ontario Shoulder Instability Index (WOSI). Secondary outcome was surgery yes/no. Results Ninety-five patients, male:female ratio 9.6:1, mean age 39.5 (range 18-59), were included. 57 patients were Rockwood type III and 38 patients were type V. There were no statistically significant differences in WOSI between patients with type III and V injuries at any time-point. Nine patients (9.5%) were referred for surgery at an average of 189 days (range 75-358) after the injury; 7 type III and 2 type V (p=0.31). Patients eventually referred for surgery had significantly worse WOSI at 6w, 3m and 6m. Conclusion Non-surgical management of Rockwood type III and V injuries shows similar and overall satisfactory results with 91% recovering well without the need of surgery.
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