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Relationship between trait mindfulness and physical activity among emerging adults: The mediating roles of exercise-related cognitive errors and trait self-control
No full textExercise-related cognitive errors (ECEs) is a significant factor that can negatively influence physical activity (PA) engagement among emerging adults, whereas mindfulness interventions may be beneficial for promoting PA. Against this background, we investigated the potential association between trait mindfulness and PA levels among emerging adults and determined whether trait self-control and ECEs serve as mediators
Ligament cell biology: Effect of mechanical loading
No full textLigaments are biomechanically specialized connective tissues that maintain joint stability and guide motion under complex loading conditions. At the cellular and molecular levels, ligament homeostasis is governed by fibroblast-like cells (ligamentocytes) embedded in an intricately organized ECM composed predominantly of type I collagen, with contributions from type III collagen, elastin, proteoglycans, and glycoproteins. These cells continuously sense and respond to mechanical stimuli-tension, compression, and shear-through mechanotransduction pathways involving integrins, focal adhesions, cytoskeletal remodeling, and mechanosensitive ion channels. Downstream signaling cascades, including MAPKs and PI3K/AKT, integrate biomechanical cues with growth factor and cytokine signaling to fine-tune gene expression, collagen fibrillogenesis, and ECM turnover. Distinct from tendons, ligaments must adapt to multidirectional loads, resulting in unique ECM compositions and cellular phenotypes. Appropriate mechanical loading maintains collagen alignment, promotes ECM integrity, and stabilizes the ligament cell phenotype. By contrast, insufficient or excessive load alters the molecular balance, triggering catabolic processes, inflammation, and disorganized ECM assembly. This delicate equilibrium also underlies the ligamentization observed in ACL graft remodeling, where controlled mechanical environments and molecular interventions accelerate the acquisition of ligamentous properties. Emerging insights into transcriptional and epigenetic regulation, growth factor-mediated cues, and cytokine-driven responses offer avenues to engineer ligament-like tissues and optimize recovery strategies. By leveraging molecular knowledge of cell-matrix interactions, growth factor profiles, and genetic/epigenetic modulators, clinicians and researchers can design tailored loading protocols, biomimetic scaffolds, and regenerative therapies. These approaches aim to restore ligament functionality, enhance graft integration, and prevent degenerative changes, ultimately improving patient outcomes in ligament injury repair and reconstruction
From placebos and shams to high-quality control interventions in manual therapy trials to study efficacy and mechanisms
No full textQualitative exploration of consultant level therapy practice in critical care
No full textIntroduction:Non-medical consultant level roles have been in existence for over 30 years, however the number of allied health professionals (AHPs) working at this level, particularly in critical care, remains relatively small. National guidance highlights the importance of clinicians in these roles to work across the four pillars of practice. However, little research exists regarding the roles undertaken by these consultant-level practitioners, the contributions made to service delivery and their perceived impact on patient and service outcomes. Based on this, the aim of this project was to explore the perceived impact of consultant-level AHPs working within critical care.
Methods:Qualitative methodology was used involving a combination of interviews and focus groups. Purposeful sampling was used to recruit AHPs in consultant-level positions within critical care. Senior medical and nursing staff were then recruited via the AHPs. Data were analysed thematically using the Braun and Clarke methodology.
Results:Five consultant-level AHPs were recruited to participate in interviews, with a further 7 participants from senior medical and nursing roles participating in one of two focus groups. The AHPs had been in a consultant-level role for an average of 3.2 years, with all participants reporting over 15 years’ experience within critical care. Four core themes were generated from 105 unique codes and 13 subthemes. Personal characteristics were apparent across all themes and therefore was included as a central element. The core themes were (1) scope; (2) status; (3) supportive leadership and (4) impact.
Discussion:Through four core themes, this study has highlighted the roles undertaken by consultant-level AHPs working in critical care, their perceived impact on patient and service outcomes, and their contribution to local, regional and national workstreams. Where these roles exist, they appear to be well received by senior medical and nursing staff, reporting the benefits of highly experienced members of clinical staff to improve service delivery, patient outcomes and contribute to strategic planning
Program standards and student competencies among global chiropractic accreditation agencies: a content analysis
No full textBackground Accreditation of healthcare provider training programs ensures graduate competency and provides a
means for programs to improve. Accreditation consistency assures the public that healthcare providers have similar
basic training across world regions. Currently, it is unknown if chiropractic accrediting agencies have congruent
standards globally. Therefore, the purpose of this study was to investigate similarities and differences in student
competencies and program standards among four chiropractic accreditation agencies worldwide.
Methods A quantitative content analysis was performed on accreditation standards from regional international
accreditation agencies responsible for accrediting the majority of the world’s chiropractic degree programs. Agencies
included the Council on Chiropractic Education (United States), the European Council on Chiropractic Education
(Europe, United Kingdom, South Africa), the Council on Chiropractic Education Australasia (Australia, New Zealand,
Malaysia), and the Council on Chiropractic Education Canada (Canada). The contents of the accrediting standards
were coded using a standardized coding list. A modified Delphi technique was used by 21 international experts from
December 1, 2023, to April 18, 2024. After four rounds of consideration to achieve consensus, the contents were
analyzed for frequency and congruence of coded items across the accrediting agencies’ standards. A two-way analysis
of variance was conducted to identify if there were any differences among the accreditation agencies.
Results Neither student competencies [F(3,8)=0.007, p>.05] nor program standards [F(3,4)=0.002, p>.05] differed
significantly across the accrediting agencies. The statistical relationships between accreditation agencies and
coding frequencies remained stable across all coded items, with no single code exhibiting differential performance
depending on the accrediting body. The overall model showed R2=0.96 for student competencies and R2=0.87 for
program standards; thus, the models’ predictions align with the observed data.
Conclusions The study findings demonstrate congruence for student competencies and program standards
among chiropractic accreditation agencies across multiple geographic regions. The patterns of content were stable
Evaluating Nigeria's progress working towards achieving SDG 6: A systematic literature review
No full textBuilding a better and sustainable future remains a target of the global community, SDGs a universal urgent call to action to achieving this by 2030. Of particular interest in implementation is SDG 6, recent reports revealing that two-third of the population in Nigeria lack access to safe water, sanitation and hygiene services; responsible for the rising burden of WBDs in the country. In an attempt to evaluate Nigeria’s progress so far in meeting SDG 6, this SLR seeks to ascertain the availability and level of access to safe water supply, sanitation and hygiene practices, and patterns of WBDs. The PEO model was utilized to generate a research question, and a comprehensive search through databases done, utilizing key words such as “safe and clean water”, “sanitation facilities”, “hygiene practices” and “water-borne diseases”. Following the PRISMA guideline, a total of 11 studies were finally included in this review having met the inclusion criteria, and were critically appraised for the quality of evidence. Synthesis of
findings gathered from included studies were developed through thematic analysis and presented in a tabular form. It was revealed that unimproved water sources were the main source of water supply, lack of water treatment evident. Pit latrine was found to be the predominant toilet system. Backwardness in hygienic practices was seen as open dumping of refuse and open defecation still a common practice, diarrhea and typhoid the major WBDs. Although gaps in knowledge were identified, this SLR is expected to
provide high quality evidence to address issues of WASH promotion interventions and policy implementation; evidence-based recommendations given to ensure SDG 6 is met by 2030, which appears unlikely
The Effect of Intermittent Fasting Combined with Ad Libitum Days on Adults' Elevated Blood Pressure: A Systematic Review of Human Studies
No full textAbstractBackground:Diets utilizing intermittent fasting as an alternative method to promote weight loss have grown in popularity. However, the efficacy of intermittent among elevated blood pressure remains unclear. This review sys-tematically analyses studies investigating the effects of intermittent variations among elevated blood pressure on changes in systolic blood pressure and diastolic blood pressure. Changes in body weight, body mass index, waist cir-cumference, and energy intake were assessed as a secondary objective. Methods:The American Search Elite, CINAHL, Cochrane, MEDLINE, ProQuest, PubMed, Scopus, and grey liter-ature databases were searched for articles investigating intermittent fasting with ad libitum among adults with elevated blood pressure from Jan 2010 to Jun 2022. Results:Twelve studies met the eligibility criteria. Systolic and diastolic blood pressure generally decreased, between -2.0 to -0.04 mmHg and -3 to -0.01 mmHg, respectively. The body weight and body mass index reduced significantly (-2.85 to -0.09 kg and -1.05 to -0.03 kg/m2, respectively). The review found a waist circumference reduction of -0.67 to -0.21 cm and an energy intake reduction of -263.89 to -2.58 kcal. Conclusion:Intermittent fasting reduces systolic and diastolic blood pressure in 2-24 wk while decreasing body weight, body mass index, and energy intake. However, needs 48 wk to reduce waist circumference. This implies that it is critical to perform intermittent fasting on elevated blood pressure before the development of high blood pressure as part of a program to prevent hypertension in adults
Navigating eating, drinking and swallowing in adults: 50 top tips from A- Z
No full textThis book offers accessible and concise information to enable both student and qualified clinicians to navigate essential eating, drinking and swallowing (EDS) knowledge and equip them to meet relevant clinical competencies.
Arranged alphabetically, the book provides an A to Z of EDS assessment and management in adults, guiding readers through key aspects, from aetiologies to xerostomia and from cranial nerve assessments to videofluoroscopy. This dip in, dip out resource is packed with information of immediate clinical relevance, facilitating synthesis between theory and practice, and encourages readers to view their clients in a holistic, person-centred way. It contains printable resources and concludes with a useful appendix providing worked examples of clinical scenarios.
Divided into 50 tips to enhance practice, this pocket-sized guide is an essential resource for all trainee and newly qualified speech and language therapists, as well as more experienced clinicians moving into the field
Advancing Equitable Osteopathic Practice: Integrating Person-Centredness & Addressing Racial Biases Through the Lens of Critical Theory
No full textAs osteopaths, many of us ideally endeavour to minimise biased interpretations when evaluating the pain and distress expressed by individuals seeking treatment. However, as a product of the society we live in, we acknowledge that various unconscious biases, including racial bias, may unintentionally and spontaneously influence our view of a patient's condition and perception of pain. This paper explores the intersection of Person-Centred Care (PCC) and racial biases through critical theory in the context of osteopathic practice. It emphasises the ethical duty of healthcare professionals to deliver PCC that recognizes individual experiences, values, needs, and abilities. Racial biases within healthcare settings are identified as contributors to disparities in access, quality, and outcomes. They can also lead to bias in the clinical decision-making process requiring attention in osteopathic clinical practice.
The critical theory framework allows for the identification of opportunities and barriers to implementing PCC and equity in osteopathic practice, highlighting factors such as the impact of implicit bias and structural barriers.
As a result, osteopaths are recommended to take a proactive approach through self-awareness, challenging personal beliefs and actively engaging in cultural humility to minimise racial biases. Osteopathic education could contribute to the cultivation of cultural humility and awareness in training programmes, fostering a passion for fair healthcare among future osteopathic professionals. Ultimately, the integration of critical theory and PCC through cultural humility is presented as an approach to promoting equitable healthcare that empowers individuals
Health literacy and the role of related factors in food handlers: Based on a cross-sectional study in regional Malaysia
No full textBackground and Objectives: Research on food handlers has predominantly focused on food safety, neglecting the importance of health literacy. Health literacy plays a pivotal role in equipping an individual with healthy lifestyle and work practices. This study aims to assess the health literacy level of food handlers and evaluate determinants influencing their health literacy.
Materials and Methods: A cross-sectional study was conducted in May-August 2023 involving 274 food handlers from 46 food outlets in Kota Marudu, Sabah, Malaysia chosen from cluster random sampling. A validated questionnaire, the Health Literacy Survey Short Form 12 (HLS-SF12) was employed to assess health literacy levels alongside sociodemographic, medical illness, healthy lifestyle practices, food handling training and recent typhoid vaccination status. The inclusion criteria are food handlers working at registered food premises, aged 18 and above. The exclusion criteria are those unable to read or comprehend English or Malay language. Frequency and percentages were used to describe the studied population while chi-square and logistic regression to determine factors associated with health literacy.
Results: The majority of participants were Malaysians, female, married and possessed a secondary level of education. Among participants, 67.9% possessed good health literacy while 32.1% had low health literacy. Multiple logistic regression analysis revealed that education and under the healthy lifestyle practices factors; the annual medical examinations were significantly associated with health literacy. Food handlers who did not undergo annual medical examinations (adjusted Odds Ratio: 2.429, 95% Confidence Intervals: 1.007-5.863, p-value=0.048) and with education level below secondary (adjusted Odds Ratio: 11.305, 95% Confidence Intervals:5.735-22.287, p<0.001) were significantly associated with low health literacy.
Conclusions: Promoting routine medical check-ups and having sustainable health education tailored according to educational background will enhance health literacy among food handlers, effectively empowering to make well-informed choices, thereby improving adherence to food safety protocols and promoting positive health outcomes