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BMJ Open Oct 2023We will launch a national survey in Serbia to document the prevalence of two types of questionable health behaviours: (1) intentional non-adherence to medical...
INTRODUCTION
We will launch a national survey in Serbia to document the prevalence of two types of questionable health behaviours: (1) intentional non-adherence to medical recommendations and (2) use of traditional, complementary and alternative medicine practices, as well as the relation between the two. We will also investigate their psychological roots, including (a) 'distal' predictors such as HEXACO personality traits (plus Disintegration) and thinking dispositions (rational/experiential thinking and cognitive reflexivity), and (b) 'proximal' predictors under the umbrella 'irrational mindset' (set of unfounded beliefs consisting of conspiratorial thinking, superstition, magical health beliefs as well as selected cognitive biases), which have more content-wise overlap with the health behaviours.
METHODS AND ANALYSIS
In this cross-sectional study, a research agency will collect data from a nationally representative sample (n=1043; age 18-75 years; estimated start/end-June/November 2021) recruited online (approximately, 70% of the sample, aged 18-54; 11 years) and face-to-face (approximately, 30% of the sample, aged 55-75 years). Participants will complete a battery of tests assessing questionable health behaviours, basic personality traits, thinking dispositions, irrational mindset, sociopolitical beliefs, sociodemographic and health-related variables. Prevalence rates will be calculated using descriptive statistics. To explore the relation between (psychological) predictors and questionable health behaviours, we will use hierarchical regression and partial mediation models (path analysis or full SEM models).
ETHICS AND DISSEMINATION
Ethical Committees of the Faculty of Philosophy in Belgrade (#935/1), Faculty of Special Education and Rehabilitation (#139/1) and Faculty of Media and Communications (#228) approved the protocol. Only participants who provide informed consent will participate in the study. A research report based on the study results will be submitted to peer-reviewed journals and results will be made available to stakeholders through reports on the project website https://reasonforhealth.f.bg.ac.rs/en/ and disseminated via social media.
TRIAL REGISTRATION NUMBER
NCT05808660.
Topics: Humans; Serbia; Cross-Sectional Studies; Prevalence; Health Behavior
PubMed: 37827738
DOI: 10.1136/bmjopen-2023-075274 -
BMC Health Services Research Sep 2023Clinical academic allied health professionals can positively impact patient care, organisational performance, and local research culture. Despite a previous national...
BACKGROUND
Clinical academic allied health professionals can positively impact patient care, organisational performance, and local research culture. Despite a previous national drive to increase these roles, they remain low in number with no clear strategy for growth. Reported barriers to this growth cite organisational and economic factors with little recognition of the challenges posed to individuals. There is a lack of research to help allied health professionals understand the personal challenges of clinical academic training and practice. The aim of this study is to explore the character traits and behaviours of clinical academic allied health professionals to understand the individual attributes and strategies taken to pursue a career in this field.
METHODS
A semi-structured interview study design was used to collect data from aspiring and established clinical academic allied health professionals. Participants were recruited voluntarily through social media advertisement (aspiring) and purposively through direct email invitation (established). Participants were asked about their experience of pursuing a clinical academic career. The interviews were conducted virtually using Zoom and were audio recorded. The data were transcribed verbatim prior to reflexive thematic analysis. Informed consent was gained prior to data collection and the study was approved by the university's research ethics committee.
RESULTS
Twenty participants from six allied health professions were interviewed. We developed five themes: risk and reward, don't wait to be invited, shifting motivations, research is a team sport, and staying the course. Clinical academic allied health professionals demonstrated traits including inquisitiveness, intuition, motivation, and resilience. The source of their motivation was rooted in improving clinical services, conducting research, and personal achievement.
CONCLUSION
Clinical academic allied health professionals describe personal traits of high inquisitiveness, opportunism, motivation, and determination in pursuing their career ambitions. The tolerance of rejection, failure, and risk was considered important and viewed as an essential source for learning and professional development. Future research should concentrate on ways to reduce the over-reliance on individual strength of character to succeed in this field and explore programmes to increase the preparedness and support for clinical academics from these professions.
Topics: Humans; Motivation; Qualitative Research; Allied Health Occupations; Allied Health Personnel; Data Collection
PubMed: 37741969
DOI: 10.1186/s12913-023-10044-2 -
Clinical Spine Surgery Mar 2024Retrospective case series and systemic literature meta-analysis. (Meta-Analysis)
Meta-Analysis
STUDY DESIGN
Retrospective case series and systemic literature meta-analysis.
BACKGROUND
Thoracolumbar junction region stenosis produces spinal cord compression just above the conus and may manifest with symptoms that are not typical of either thoracic myelopathy or neurogenic claudication from lumbar stenosis.
OBJECTIVE
As few studies describe its specific pattern of presenting symptoms and neurological deficits, this investigation was designed to improve understanding of this pathology.
METHODS
A retrospective review assessed surgically treated cases of T10-L1 degenerative stenosis. Clinical outcomes were evaluated with the thoracic Japanese Orthopedic Association score. In addition, a systematic review and meta-analysis was performed in accordance with guidelines provided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA).
RESULTS
Of 1069 patients undergoing laminectomy at 1477 levels, 31 patients (16M/15F) were treated at T10-L1 a mean age 64.4 (SD=11.8). Patients complained of lower extremity numbness in 29/31 (94%), urinary dysfunction 11/31 (35%), and back pain 11/31 (35%). All complained about gait difficulty and objective motor deficits were detected in 24 of 31 (77%). Weakness was most often seen in foot dorsiflexion 22/31 (71%). Deep tendon reflexes were increased in 10 (32%), decreased in 11 (35%), and normal 10 (32%); the Babinski sign was present 8/31 (26%). Mean thoracic Japanese Orthopedic Association scores improved from 6.4 (SD=1.8) to 8.4 (SD=1.8) ( P <0.00001). Gait subjectively improved in 27/31 (87%) numbness improved in 26/30 (87%); but urinary function improved in only 4/11 (45%).
CONCLUSIONS
Thoracolumbar junction stenosis produces distinctive neurological findings characterized by lower extremity numbness, weakness particularly in foot dorsiflexion, urinary dysfunction, and inconsistent reflex changes, a neurological pattern stemming from epiconus level compression and the myelomeres for the L5 roots. Surgery results in significant clinical improvement, with numbness and gait improving more than urinary dysfunction. Many patients with thoracolumbar junction stenosis are initially misdiagnosed as being symptomatic from lumbar stenosis, thus delaying definitive surgery.
Topics: Humans; Middle Aged; Constriction, Pathologic; Retrospective Studies; Hypesthesia; Lumbar Vertebrae; Thoracic Vertebrae; Back Pain; Spinal Stenosis
PubMed: 37735761
DOI: 10.1097/BSD.0000000000001539 -
Molecules (Basel, Switzerland) Aug 2023The traditional use of L. roots to enhance male sexual performance prompted us to assess the in silico, in vitro, and in vivo aphrodisiac activities of its...
The traditional use of L. roots to enhance male sexual performance prompted us to assess the in silico, in vitro, and in vivo aphrodisiac activities of its hydroethanolic extract using normal male rats. Spectroscopic characterization indicated the presence of ß-D-glucopyranoside, methyl-1,9-benzyl-2,6-dichloro-9H-purine, and Bis-(2-ethylhexyl)-phthalate; these compounds have a significant inhibitory effect on the phosphodiesterase-5 (PDE-5) enzyme in silico evaluation and minerals (including zinc, cadmium, and magnesium). Other phytochemical analyses revealed the presence of phenolic compounds and flavonoids. These phytochemicals and minerals may contribute to the aphrodisiac activities of the extract. Additionally, the in vivo study revealed that the administration of root extract (300 mg/kg) significantly enhanced ( < 0.01, < 0.03) mount, intromission, and ejaculation frequencies while significantly ( < 0.05) decreasing the mount and intromission latencies, as well as the post-ejaculatory interval time, in comparison with the standard drugs sildenafil and ginseng, resulting in enhanced erection and sexual performance in the rats. Furthermore, the extract significantly ( < 0.05) increased penile reflexes and also elevated the levels of testosterone and luteinizing hormones. Extract (300 mg/kg) significantly ( < 0.05) inhibited the PDE-5 enzyme in an in vitro study. Concludingly, the comprehensive findings of this study suggest that a standardized herbal extract derived from roots alleviates erectile dysfunction and premature ejaculation in male rats. root extract proved to be an alternative treatment for erectile dysfunction and premature ejaculation.
Topics: Male; Animals; Rats; Humans; Aphrodisiacs; Mirabilis; Erectile Dysfunction; Premature Ejaculation; Phytochemicals; Plant Extracts
PubMed: 37687143
DOI: 10.3390/molecules28176314 -
Physiotherapy Theory and Practice Aug 2023Clinician bias contributes to health disparities; therefore, educational standards and professional expectations incorporate cultural humility. Vague standards and...
BACKGROUND
Clinician bias contributes to health disparities; therefore, educational standards and professional expectations incorporate cultural humility. Vague standards and numerous pedagogical methods make implementing an effective and uniform curriculum challenging. Classroom and clinical faculty's attitudes and behaviors are pivotal; however, evidence on roles beyond instruction is lacking.
PURPOSE
This study explored physical therapy (PT) students' perceptions of faculty's role in improving their cultural humility.
METHODS
This study was rooted in a phenomenological approach that incorporated elements of both descriptive and interpretive phenomenology. Thirteen first-year PT students participated in one-on-one interviews which underwent reflexive thematic analysis.
RESULTS
Reflexive thematic analysis generated two hundred-ninety codes, six categories, and one overarching theme. Dissonance emerged between students' perceptions of faculty's role and the explicit and implicit curriculum.
CONCLUSION
Explicit messaging from classroom instruction and implicit messaging from clinical encounters and unspoken attitudes, values, and behaviors were disparate. Faculty role modeling, diversity, cultural awareness, and perceived comfort interacting with a diverse patient population improved students' self-confidence and cultural humility. Professional development including field experience with a cognitive apprenticeship approach, and standardized, discipline-specific cultural humility competencies may provide uniform and clear guidelines.
PubMed: 37647271
DOI: 10.1080/09593985.2023.2252053 -
Sociology of Health & Illness Jan 2024Identity loss and (re)construction forms a central debate in sociology of chronic illness. Living with chronic/persistent health conditions may raise questions about how...
Identity loss and (re)construction forms a central debate in sociology of chronic illness. Living with chronic/persistent health conditions may raise questions about how disruptions can touch upon and further threaten the very roots of existence, by which people reflexively perceive a coherent and stable sense of 'being-in-the-world'. Whilst medical sociologists have shown interest in 'existential loss' in chronic illness, this question remains largely underexplored. Adopting a qualitative study on Long COVID (LC) as an example, this article illuminates existential identity loss as a deeply painful experience of losing body as a fundamental medium to retain continuity and consistency of one's narratively constructed identity. Interviews with 80 LC sufferers in the UK revealed that living with persistent and often uncertain symptoms and disruptions can cause the loss of biographical resources and resilience, making it difficult to reflexively understand their own being within the world. Their dynamic responses to LC also highlighted how sufferers' longing for a narratively coherent self can profoundly shape the ongoing construction of their identity in chronic health conditions. These insights into the complicated and often hard-to-express existential pain of identity loss can also nurture more holistic understandings of and support for LC and chronic illness more broadly.
Topics: Humans; Post-Acute COVID-19 Syndrome; COVID-19; Existentialism; Chronic Disease; Qualitative Research; Pain
PubMed: 37391994
DOI: 10.1111/1467-9566.13690 -
Theoretical Medicine and Bioethics Oct 2023This work begins with a brief review - from the physical education movement that began in ancient Greece and is deeply rooted in 19th century Europe, to the somatics... (Review)
Review
This work begins with a brief review - from the physical education movement that began in ancient Greece and is deeply rooted in 19th century Europe, to the somatics movement alive today. The review captures primary historical and conceptual references, relevant to the therapeutic-embodied exploratory work. Then, G. Stanghellini's mental health care model [2] is reviewed. This model is considered within reflexive self-awareness and spoken dialogue: the main vehicles in relation with alterity and its consequences in the realm of psychotherapeutic encounter and intervention. This will highlight the individual's bodily movement and inter-corporeal 'proto-dialogue' as a prior realm of therapeutic intervention. Next, a brief consideration of E. Strauss work [31] is presented. This paper's hypothesis is that bodily qualitative dynamics highlighted by phenomenology are essential for an effective mental health therapeutic intervention. A 'seed' of a framework is proposed in this paper; this seed assesses some phenomenological assets of a positive conception of mental health, for which self-awareness education is key to develop skills such as kinaesthetic intelligence and attunement and to educate healthy persons who can promote edifying social relations and environments.
Topics: Humans; Mental Health; Europe; Psychopathology
PubMed: 37231205
DOI: 10.1007/s11017-023-09618-2 -
Medical Education Nov 2023Ensuring that students transition smoothly into the identity of a doctor is a perpetual challenge for medical curricula. Developing professional identity, according to...
BACKGROUND
Ensuring that students transition smoothly into the identity of a doctor is a perpetual challenge for medical curricula. Developing professional identity, according to cultural-historical activity theory, requires negotiation of dialectic tensions between individual agency and the structuring influence of institutions. We posed the research question: How do medical interns, other clinicians and institutions dialogically construct their interacting identities?
METHODS
Our qualitative methodology was rooted in dialogism, Bakhtin's cultural-historical theory that accounts for how language mediates learning and identity. Reasoning that the COVID pandemic would accentuate and expose pre-existing tensions, we monitored feeds into the Twitter microblogging platform during medical students' accelerated entry to practice; identified relevant posts from graduating students, other clinicians and institutional representatives; and kept an audit trail of chains of dialogue. Sullivan's dialogic methodology and Gee's heuristics guided a reflexive, linguistic analysis.
RESULTS
There was a gradient of power and affect. Institutional representatives used metaphors of heroism to celebrate 'their graduates', implicitly according a heroic identity to themselves as well. Interns, meanwhile, identified themselves as incapable, vulnerable and fearful because the institutions from which they had graduated had not taught them to practise. Senior doctors' posts were ambivalent: Some identified with institutions, maintaining hierarchical distance between themselves and interns; others, along with residents, acknowledged interns' distress, expressing empathy, support and encouragement, which constructed an identity of collegial solidarity.
CONCLUSIONS
The dialogue exposed hierarchical distance between institutions and the graduates they educated, which constructed mutually contradictory identities. Powerful institutions strengthened their identities by projecting positive affects onto interns who, by contrast, had fragile identities and sometimes strongly negative affects. We speculate that this polarisation may be contributing to the poor morale of doctors in training and propose that, to maintain the vitality of medical education, institutions should seek to reconcile their projected identities with the lived identities of graduates.
PubMed: 37218311
DOI: 10.1111/medu.15109