Contemplation Phase Research Articles

Two Contemplation Models of Nāmamātra in the Yogācāra Literature

This article contextualizes the meaning of nāmamātra in the Mahāyānasūtrālaṃkārabhāṣya and explores the history of modifications of this term in the Yogācāra literature. The term already exists in the pre-Yogācāra literature, such as the Aṣṭasāhasrikā Prajñāpāramitā and the Bhavasaṃkrāntisūtra, where it means name only. The chapter Bodhisattvabhūmi of the Yogācārabhūmi applies this meaning and explains how to interpret it to understand the true nature of the contemplative object; that is, what is named is nothing but a name, and what exists is the inexpressible thing (vastu). When people lack this understanding and regard for the expressed object as existent, they suffer subsequent afflictions and suffering. A similar but slightly modified explanation is also found in the Madhyāntavibhāgabhāṣya, where the author states that a single object has two intrinsic characteristics (svalakṣaṇas), the conventional and the ultimate, and that the former is expressed by a mere name and is non-existent, while the latter is ineffable and existent. However, the Mahāyānasūtrālaṃkārabhāṣya and Sthiramati’s commentary on it, the *Sūtrālaṃkāravṛttibhāṣya, insert another meaning of nāmamātra: there are only mental factors. They also describe two contemplation phases, whereby practitioners should first understand the non-existence of the expressed object before recollecting the term nāmarūpa in the context of the five constituents (pañcaskandha) and concluding that material and physical factors (rūpa) do not exist; rather, only the mental factors do (nāmamātra). Finally, this second meaning of nāmamātra should be further contemplated, and the mere mental factors should also be regarded as ultimately non-existent because the external objects causing them were already considered non-existent. This examination of various Yogācāra explanations of nāmamātra sheds light on the multiple phases of modifications of Buddhist terms that occurred in the Yogācāra literature during the systematization of Yogācāra contemplation.

Breaking the plastic habit: Drivers of single-use plastic reduction among Thai university students.

This study investigated the decision-making dynamics for pro-environmental behavior among Thai university students, focusing on reducing the consumption of single-use plastics (SUP). By adopting a dynamic approach to the Theory of Planned Behavior (TPB), the research examined the influence of psychosocial factors, including attitudes, perceived behavioral control, and subjective norms, on SUP reduction intention at different phases of behavior change. Using structural equation modelling, we analyzed quantitative data (n = 317) from the selected universities. The results revealed that attitudes predicted behavioral intentions only among individuals in the contemplation phase of reducing SUP. Attitudes had a small but limited influence on the behavioral intentions of students who had not yet acted. Perceived behavioral control, on the other hand, significantly impacted behavioral intentions across all phases of behavior change, highlighting its importance in SUP reduction. The study also confirmed subjective norms' positive influence on students' behavioral intentions in the pre-contemplation phase. Practical implications suggested segmenting residents based on their behavior change phase so that public policymakers can allocate resources more efficiently and effectively by tailoring campaigns to specific behavior change phases, ultimately promoting sustainable behavior among university students.

Adaptive Mechanism for Water and Wastewater Construction Companies in Coping with the Disruption of Projects Due to Crisis

The water and wastewater construction company (WWCC) plays an important role maintaining water sustainability for human. It is a very intricate industry vulnerable to disruptions, delays, and disputes in times of crisis or pandemic. It is a system that has internal interactions on its 5Ms of management such as Man, Material, Machine, Method, and Money that are sensitive to change affected by external environment which in turn affected their current projects. One of the external factors that affected WWCC in the year 2020 is the occurrence of coronavirus covid19. During the pandemic, the global construction industry including WWCC have experienced drastically altered risk environment applied to funding, labor shortages, material delays, suspension, and termination of contracts (Barriere 2020). The pandemic has affected WWCC’s 5Ms of management that ranges that eventually affected the triple constraints of projects such as scope, time, and cost. The study has determined the level of severity of the effect before and during covid19 to WWCC’s 5Ms of management that eventually affected the three interdependent constraints of projects. The data gathered before and during covid19 were compared and ultimately utilized in formulating the adaptive mechanism for WWCC in coping with the disruption of projects during crisis. The adaptive mechanism comprises of the precontemplation and contemplation phases. During pandemic, WWCC has to determine if there is a need for change in their organization. They have to adapt through precontemplation through internal and external scanning and situational analysis in order for them to comprehend and adapt to the change. WWCC upon realizing of the needed change, has to continue with the contemplation stage by utilizing the stop, start and continue (SSC) principle. To be more precise with the implementation of change, WWCC has to exercise pause, focus and identify prior to executing the SSC principle, followed by implementation, action, and maintenance.

Predictor of smoking cessation among school-going adolescents in Indonesia: a secondary analysis based on the transtheoretical model of behavioral change.

This study elucidates the complex journey of adolescents toward smoking cessation, investigating the association of relevant demographic factors, advertising, promotion, anti-cigarette messages, and individual knowledge and attitudes with being in different smoking cessation stages. Utilizing data from the 2019 Indonesia Global Youth Tobacco Survey, this secondary analysis included adolescents who reported ever smoking. The Transtheoretical Model (TTM) guided the categorization of the outcome variable into three smoking cessation stages based on the responses to two questions related to the intention and timing of the smoking cessation. This included contemplation, action, and maintenance stages. Multinomial logistic regression analyzed the associations between each independent variable and being in each stage of smoking cessation. The study comprised 3596 Indonesian adolescents from grades 7-12, of which 2484 responded to two questions related to intention and timing of smoking cessation and were included in regression analysis. Findings indicate that males and those aged ≥16 were predominantly in contemplation phase. Early smoking initiation, usage of other tobacco products, and exposure to various forms of smoke increased the likelihood of being in contemplation and action phases. Parental smoking, school smoking exposure, and second-hand smoke were significant contemplation phase predictors. Exposure to tobacco advertising was linked to an increased likelihood of being in contemplation and action phases, whereas anti-cigarette messages showed no significant impact. Awareness of cigarette and second-hand smoke harms reduced the odds of being in the contemplation phase, while enjoying smoking and willingness to accept cigarettes from friends increased the odds of being in contemplation and action phases rather than in maintenance phase. Addressing age, gender, cultural influences, environmental factors, and attitudes towards smoking through tailored interventions is vital for aiding smoking cessation in Indonesian adolescents. Strengthened tobacco control in schools and public places is recommended to bolster these efforts. Longitudinal studies are required to explore the evolving patterns of smoking cessation behaviors over time, enhancing our understanding of the factors influencing sustained cessation.

Clinical Practice Guidelines for Assessment and Management of Patients with Borderline Personality Disorder.

Clinical Practice Guidelines for Assessment and Management of Patients with Borderline Personality Disorder.

Factors influencing the practice of Smoking Cessation Assessment and Management among Primary Care Doctors (SCAAM-DOC) in three districts of Malaysia.

Smoking prevalence remains high in Malaysia. Primary care doctors have a good opportunity to motivate the smokers to quit smoking in view of the accessibility of primary healthcare clinics to the public. The objective of this study was to determine the practice of smoking cessation management among primary care doctors and its associated factors. A cross-sectional online survey was carried out among 383 medical officers and interns in all government primary healthcare clinics in the district of Petaling, Klang and Hulu Langat from June to August 2020. All doctors were involved in the care of patients for smoking cessation. The knowledge, attitude and practice of smoking cessation management were assessed using a 17-items validated questionnaire which covered the components of 5As (Ask, advise, assess, assist, arrange) and 5Rs (Relevance, risk, reward, roadblocks, repetition). The management of pre-contemplation phase included the components of ask, advise, assess and 5Rs. The management of the contemplation phase included the components of assist and arrange. The majority of the respondents had poor score of knowledge (62.4%); attitude (58%) and practice (pre-contemplation management:50.9%; contemplation management:75.7%). Using multivariate logistic regression analysis, the significant factors associated with the poor practice of smoking cessation management in the pre-contemplation phase were poor (OR = 2.14, 95% CI 1.11-4.12, p <0.01) or moderate knowledge (OR = 2.50, 95% CI 1.19-5.26, p<0.01), poor attitude (OR = 2.16, 95% CI 1.39-3.37, p<0.01), lacks smoking cessation banners, brochures and leaflets in the clinic (OR = 2.01, 95%CI 1.26-3.19, p<0.01) and lack of nicotine replacement medications (OR = 2.27. 95%CI 1.27-4.06, p<0.01). No significant factors were shown associated with the practice of the contemplation phase. The majority of primary care doctors had poor knowledge, attitude and practice of smoking cessation management. Factors that had increased the odds of the poor practice of smoking management at the pre-contemplation phase were poor knowledge, poor attitude, and insufficient organizational support for health promotion materials and nicotine replacement medication.

Evaluation of Perceptions of Tobacco Cessation among the Individuals Attending a Tertiary Care Dental Hospital - A Mixed Methods Design.

Introduction:In India every year, an estimated 1 million people die from tobacco-related illnesses, which could have been avoided by stopping tobacco use. This study aimed to determine the tobacco dependence and perceptions about tobacco cessation among the patients attending a tertiary care dental hospital. Methods:A mixed-methods study was conducted among the individuals visiting the dental hospital. Self-administered questionnaires were used to record quantitative data on the current and past tobacco history, tobacco dependence, and quit attempts. Face-to-face interviews were conducted to collect qualitative data on the perceptions on tobacco quitting. Results:About 52% of participants had made an attempt to quit tobacco in the past. The majority of the smokers (82.7%), smokeless tobacco (SLT) users (71.3%), and dual users (83.1%) reported being in the contemplation phase of quitting tobacco. SLT users (12.3%) reported to have taken action in the past to quit tobacco compared to 9.6% smokers, and 1.4% of dual users. Doctors advise, motivation from family and friends motivated the participants to quit tobacco. The risk perception of tobacco use was reported as death, cancer, dental diseases, systemic diseases like chest congestion, cough, tuberculosis, lung cancer, and general body weakness. However, some of the participants were unaware of the methods to quit tobacco, some had misconceptions that shifting to other forms of tobacco and alcohol could help in quitting, and considered SLT to be less harmful than smoking forms.Conclusion:Majority of the participants were willing to quit tobacco and had taken measures to quit in the past. There is a need to increase the awareness among the tobacco users about the health risk of tobacco use, and motivate them to utilize the existing cessation services available.

The effect of theory - Based educational intervention on consumption of smokeless tobacco products by merchants' guilds.

BACKGROUND:Smokeless tobacco (SLT) products are highly addictive and contain at least 28 carcinogenic chemicals. The purpose of this study was to determine the effect of theory-based on the Transtheoretical Model of Behavior Change on consumption of SLT products by Merchants’ Guilds in 2018.MATERIALS AND METHODS:The present quasi-experimental research was conducted over one intervention group. The research population consisted of all consumers of the SLT products among the merchants’ guilds in Chabahar City, Iran in 2018. Data were gathered from 320 individuals by simple random sampling using a valid and reliable researcher-made questionnaire. The intervention program was designed based on the Transtheoretical Model of Behavior Change cognitive processes and lasted 6 months. After the intervention, the same questionnaires were administered among the participants. The data were analyzed by SPSS version 20 using the descriptive and analytical tests.RESULTS:In the preintervention phase, the participants’ mean scores of the cognitive processes at the precontemplation, contemplation, and preparation stages were 29.16 ± 4.63, 25.07 ± 3.84, and 12.12 ± 1.63, respectively. At the postintervention phase, mean scores of the precontemplation, contemplation, and preparation stages reached to 40.5 ± 5.96, 38.8 ± 5.03, and 35.5 ± 4.23, respectively. Furthermore, the participants’ mean sores at the action and maintenance stages were 36.4 ± 4.57 and 43.3 ± 3.29, respectively. According to the ANOVA, a significant relationship was found between cognitive processes at the preintervention phase and stages of change (P < 0.001).CONCLUSIONS:Individuals can improve from the precontemplation, contemplation, and preparation phases to the action and maintenance stages by attending based on Transtheoretical Model of Behavior Change educational interventions. It is suggested that the structure of this model be used to reduce high-risk behaviors in other occupations.

The Effectiveness of the Transtheoretical Model to Improve Physical Activity in Healthy Adults: A Systematic Review

Despite the known risks of physical inactivity, only 50% of adults meet the recommended guidelines for physical activity (PA). Therefore, numerous interventions have been designed to increase PA across a lifespan. The purpose of this systematic review was to determine the effectiveness of interventions based on the transtheoretical model to improve PA in healthy adults. Electronic databases (CINAHL, MEDLINE, Psychology & Behavioral Sciences Collection, PsycINFO, Sociological Collection, and SPORTDiscus) were systematically searched from January 2001 to May 2020. A total of 11 randomized pretest-posttest studies were included in this review. Ten studies utilized a subjective measurement of PA, and 3 studies included an objective measure. Five studies demonstrated significant improvements in PA for the transtheoretical model-based intervention groups compared with control/comparison groups; however, 6 studies demonstrated no differences between groups. The findings suggest that there is inconsistent evidence to support the use of interventions based on the transtheoretical model to improve PA in adult populations. Interventions were more successful when materials were delivered via in-person counseling and when study participants were in the precontemplation or contemplation phases at baseline.

Advance directives in Austrian intensive care units: An analysis of prevalence and barriers

PurposeTo investigate the prevalence of advance directives, healthcare proxies, and legal representatives in Austrian intensive care units (ICUs), and to explore barriers faced by adults engaged in the contemplation and documentation phase of the advance care planning process. MethodsTwo studies were conducted: (1) A 4-week multicenter study covering seven Austrian ICUs. A retrospective chart review of 475 patients who presented to the ICUs between 1 January 2019 and 31 January 2019 was conducted. (2) An interview and focus group study with 12 semi-structured expert interviews and three focus groups with 21 adults was performed to gain insights into potential barriers faced by Austrian adults planning medical decisions in advance. ResultsOf the 475 ICU patients, 3 (0.6%) had an advance directive, 4 (0.8%) had a healthcare proxy, and 7 (1.5%) had a legal guardian. Despite the low prevalence rates, patients and relatives reacted positively to the question of whether they had an advance directive. Patients older than 55 years and patients with children reacted significantly more positively than younger patients and patients without children. The interviews and focus groups revealed important barriers that prevent adults in Austria from considering planning in advance for potentially critical health states. ConclusionThe studies show low prevalence rates of healthcare documents in Austrian ICUs. However, when patients were asked about an advance directive, reactions indicated positive attitudes. The gap between positive attitudes and actual document completion can be explained by multiple barriers that exist for adults in Austria when it comes to planning for potential future incapacity.

Nicotine Dependence, Readiness to Change Behavior among Tobacco Users Attending Tertiary Care Hospital's De-Addiction Clinic in Uttarakhand

Introduction: Tobacco use is a significant cause of many respiratory diseases and preventable deaths in India. The crunch of information on the magnitude of the tobacco use problem unable to planned and implement tobacco cessation programs in the Himalayan region. This study aims to determine nicotine dependence and readiness to change behavior in tobacco users attending a tertiary care teaching hospital's de-addiction clinic. Materials and Methods: This descriptive study purposively included 120 tobacco users over 6 months in a public hospital's de-addiction clinic, North India. A structured personal and clinical profile sheet, the Fagerstrom Test for Nicotine Dependence-Revised Version-smokable and smokeless), and Readiness to Change Questionnaire (RCQ) were used to collect information. Descriptive and inferential statistics were used to generate the findings. Results: The mean age of tobacco initiation was 20.69 (±6.12) years in the study population, with a median ofthree quit attempts (median: 3; interquartile range: 2–5). Nearly 55.8% and 18.3% of participants were using smokable and smokeless tobacco, respectively. Bidi was the most preferred (75.8%) form of smokable tobacco among study participants. The majority of participants were in the category of high nicotine dependence (76.6%) as per the FTND scale and were in the contemplation phase (55%), whereas 45% of the users found it in the action stage of quitting tobacco. Conclusions: The majority of the participants were in the high nicotine dependence stage. However, readiness to change behavior to quit or reduce tobacco use is noteworthy, emphasizing need-based intervention and assisted follow-up programs to tobacco users in the outpatients.

Values-Based Interventions in Patient Engagement for Those with Complex Needs.

The objective was to evaluate a novel intervention that integrates a psychological, values-based approach with coordinated care management. This paper describes an integrated comprehensive health record system to enhance engagement with a subset of those with complex needs; those who are high-needs, high-cost (HNHC). Patients are selected after conducting data analysis on the most costly and complex patients of a payer system that works with HNHC patients. Specifically, the Patient Care Intervention Center in Houston TX, applies the values-based intervention to HNHC patients. This pilot study reports data from 18 HNHC patients over 6 months; specifically, outcomes related to daily functioning, depression, working alliance, stages of change, and overall well-being. Additionally, this paper reports preliminary findings from qualitative monitoring of provider experiences implementing the values-based approach and integrated evaluation. HNHC patients improved their daily functioning over 4 months but no other significant changes were found over time. Patients self-reported mild depression, strong working alliances with their provider, being in the contemplation phase of change, and moderate well-being. There also was variation when patients completed the assessments and data points were collected. Although this is a small sample and short time frame, preliminary results suggest that the intervention has a positive impact on HNHC patient daily functioning. Provider accounts of the implementation describe using the evaluation items to inform their interactions with patients, and also suggest that patient literacy level impacts when data can be collected. Other changes to the approach are suggested.

The Universal Transformational Management Framework (UTMF)

Purpose The purpose of this paper is to present the development and validation of the Universal Transformational Management Framework (UTMF), an entrepreneurial tool that guides the development of inclusion-driven strategic management, planning and practice in sport organizations. Design/methodology/approach A range of qualitative data collection techniques was undertaken in this action research: seven cross-sectoral semi-structured interviews; one focus group with sports professionals; a qualitative survey and research group consultations. A matrix analysis, a thematic analysis and secondary research were undertaken to analyze data. Findings The UTMF is a staged framework that embeds principles of behavioral, organizational and transformative change theory, guiding strategic development toward inclusion from a contemplation phase toward an action and maintenance stage. The UTMF is composed of 14 fundamental components identified as key areas that sport entrepreneurs should recognize and address for planning and delivering sport services that leave no one behind. Practical implications Policy makers, management and sport professionals have at their disposal an inclusion-driven framework that challenges their systems and establish mechanisms to leave no one behind. Social implications Organizational transformation can ultimately produce a contagion effect advancing equality and inclusion in society. The UTMF offers a structure for sport entrepreneurs aiming to facilitate and activate social transformation in and through sport. Originality/value The UTMF is a wide-ranging framework to facilitate an orchestrated transformation of sport organizations in order to provide universal services that include marginalized groups and address global challenges identified in intersectional agendas like the SDGs.

Profile of Alcohol-Dependent Patients Admitted in De-addiction Ward of Tribhuvan University Teaching Hospital (TUTH), Kathmandu

Introduction: Alcohol dependence is a global problem worldwide and the global burden of disease study published in 2010 concluded alcohol use to be the third leading risk factor for death and disability. This study was conducted to find out the diagnostic profile, socio- cultural determinants, motivation level and other related variables in patients diagnosed as alcohol dependence in hospital admitted patients.Material and Method: This was a cross- sectional study carried out in patients diagnosed as alcohol dependence and admitted in the deaddiction ward of Tribhuvan University Teaching Hospital over a period of eight months. SPSS version 18 was used for the statistical analysis of the data obtained.Results: A total of 86 patients were admitted during the period of 8 months. Among those, 48% were admitted with the diagnosis of alcohol dependence- complicated withdrawal while remaining 52% were admitted with alcohol dependence- uncomplicated withdrawal. Assessment of motivation revealed that majority of the patients i.e.43% were in precontemplation phase, 27.9% were in the contemplation phase, 9.3% were in preparation phase, and 19.8% were ready to take action for remaining abstinent. Sociodemographic variables were not statistically significant except for family type where more than 70% of patients with complicated withdrawal belonged to nuclear family when compared to uncomplicated withdrawal.Conclusion: In this study, we assessed the overall profile of patients admitted with alcohol dependence syndrome in a tertiary care hospital so that this data can be used for better management of our patients.J Psychiatrists’ Association of Nepal Vol .6(1), 2017, p.38-43

Capsule Commentary on Danan et al., Does Motivation Matter? Analysis of a Randomized Trial of Proactive Outreach to VA Smokers.

I n this multicenter randomized controlled trial, the authors examined the effectiveness of proactive smoking cessation intervention and its impact on veteran smokers’ level of motivation to quit.Using the transtheoretical model of behavioral stages of change (SOC), they assessed veterans’ readiness to quit smoking after categorizing them under precontemplation, contemplation, and preparation phases while receiving either usual or proactive care. SOC was assessed at baseline and follow-up with the 10-point Readiness to Quit Ladder (RQL). Proactive care offered telephone or in-person smoking cessation counseling and access to cessation pharmacotherapy. The usual care group had access to smoking cessation services through the VA, but did not receive proactive outreach. The outcomes were self-reported 6month abstinence and uptake of smoking cessation therapies and quit attempts at baseline and follow-up. The study recruited 3006 veterans of diverse age, ethnicity, and socioeconomic status (SES) representing four different VA medical centers. The authors report a statistically significant result among smokers in contemplation and preparation phases achieving prolonged abstinence after proactive care. Smokers at all SOC receiving proactive care had statistically significant uptake of smoking cessation therapies. However, there was no difference in quit attempts between proactive and usual care groups. The literature indicates that smoking is highly prevalent among veterans and remains a major cause of excess morbidity, mortality, and loss of productivity. Routine advice from providers increases the likelihood that a smoker will make a quit attempt. Studies indicate that the interventions that proactively offer evidence-based smoking cessation therapies to all smokers, regardless of SOC, may provide further opportunity for reducing smoking prevalence. Veterans with psychiatric disorders and other comorbidities smoke at higher rates, however, this information is not provided. With the exception of participation and recall biases, current findings are highly encouraging for clinicians. Clinical decision support systems (CDSS) promote the use of best practices, condition-specific guidelines, and population-based management. By leveraging CDSS within the electronic medical record (EMR), VA providers can identify at-risk groups, and can provide evidence-based risk assessment and targeted intervention to our veteran smokers. Future studies should utilize electronic tools, including CDSS, to enhance proactive outreach strategies while providing tobacco cessation therapy.

Community-Based Health Education and Communication Model Development for Opisthorchiasis Prevention in a High Risk Area, Khon Kaen Province, Thailand

This study aimed to evaluate the impact of a community-based health education and communication programme on reducing liver fluke infections caused by the consumption of uncooked fish among people in a high-risk area of Thailand. The study was quasi-experimental in nature, with three-stages. Stage 1 involved a situational and capacity analysis of designated communities in Khon Kaen province. This was followed by the development of a model for community-based health education and communication to prevent liver fluke infections among high-risk people, and, lastly, implementation and evaluation of the model were performed. Data were collected using both qualitative and quantitative methods. In total, 390 people were surveyed, and quasi-experimental and comparison groups, each with 90 people, were assessed between May 2011 and April 2012. Analysis was using statistical OR, 95 % CI, the Willcoxon matched pairs signed ranks test, the chi-square test, and the Mann-Whitney U test. The findings showed that most respondents had a high level of knowledge and understanding of liver fluke disease (89.5%, 95% CI:86.0-92.4), and positive attitudes toward the prevention of the disease (94.4%, 95% CI:91.6-96.4). However, with regard to changes in consumption of uncooked fish, most respondents were still in the pre-contemplation phase (55.1%, 95% CI:50.0-60.1), followed by the contemplation phase, 22.6%. Furthermore, four factors were found to be associated with the consumption of uncooked fish--the consumption of alcohol (OR 4.16, 95% CI:1.79-9.65), gender (OR 3.17 , 95% CI:1.53-6.54), smoking (OR 3.03, 95% CI:1.31-7.05), and age 40 years and above (OR 2.68, 95% CI:1.02-7.05). After nine months of the health education and communication programme using local media based on local wisdom, culture and persons, the results showed that, compared to the control group, members of the experimental group had a higher level of knowledge, a better attitude and lower levels of ill- advised consumption behaviour. Also, it was found that consumption of uncooked fish, by an assessment of the level of stage of change, was reduced. (p-value 0.002). The health education and communication programme developed as part of the study was effective in changing the consumption of uncooked fish. Therefore, this approach should be promoted in other high-risk areas in Thailand in the future.

Poligami dalam Teori Hermeneutika Muhammad Shahrûr

Muhammad Shah}rûr was a liberal philosopher from Suriah. Most scholars who study Shahrûr’s thought split into 3 phases of his thinking. The first phase, 1970 - 1980 is the contemplation phase. This phase is more influenced by the thought of &lt;em&gt;taqlîd&lt;/em&gt; which is inherited and present in the old Islamic heritage and modern one, as well as a tendency in the Islamic ideology (&lt;em&gt;‘Aqîdah&lt;/em&gt;) either in the form of &lt;em&gt;kalâm&lt;/em&gt; and &lt;em&gt;fiqh&lt;/em&gt; schools. The second phase is between the years of 1980 - 1986 is the phase where Shahrûr began to deliver his ideas and his interest into language studies, philosophy and understanding of the Qur’an. The third phase is between the years of 1986 - 1990 which Shahrûr began intensively arranges his thoughts in the topic of Islamic thoughts. In some aspects of his interpretation, He rejected Prophet Muhammad’s &lt;em&gt;asbâb al-nuzûl&lt;/em&gt; and it’s temporarily limit, and strengthen the arguments the rejecters of divine revelation as a verse just resting on his &lt;em&gt;asbâb al-nuzûl&lt;/em&gt; itself.

AB1379 Evaluation of interprofessional patient-centred collaborative practice behaviour and perceptions following an intensive continuing education initiative in arthritis care

BackgroundThe Advanced Clinician Practitioner in Arthritis Care (ACPAC) program prepares expereinced physical therapists and occupational therapists for extended practice roles.ObjectivesThis study assessed the practice behaviour and perceptions of ACPAC program-trained...

Reanalysis of a tailored web-based exercise programme for office workers with sub-acute low back pain: Assessing the stage of change in behaviour

Objective: To reanalyse a web-based intervention for physically untrained office workers with sub-acute non-specific low back pain in low back pain-related exercise behaviour terms. Design: Reanalysis of a randomized controlled trial. Setting: Occupational Preventive Medicine of University. Methods: Participants were randomized to an intervention group (proposed intervention plus standard care) or a control group (usual care only). The intervention exercise and education materials were developed as an online resource, and included video demonstrations recorded in a laboratory. Resources were loaded onto a dedicated section of the University Preventive Medicine Service website. All sessions included stretching, and exercises to improve postural stability (abdominal, lumbar, hip and thigh muscles) strength, flexibility and mobility. Outcome measures were self-reported health status (visual analogue scale (VAS) of the Euroquol-5D questionnaire); functional health status (Oswestry disability questionnaire); and the stage of change questionnaire. At nine months, outcomes in the intervention group were analysed and compared with baseline and outcomes in controls. Results: In the intervention group, significant positive effects were observed at nine-month follow up for stage of change in the behavioural domain as related with low back pain for all phases except for the contemplation phase. The positive change in the stage of change questionnaire correlated with the improvement observed in Oswestry (r = .388) and VAS (r = −.612). Conclusions: The reanalysis of the trial suggests that exercise behaviour related to low back pain improve after the intervention period. This improvement correlates with changes in clinical low back pain-related outcomes.

Clinical trial on the efficacy of exhaled carbon monoxide measurement in smoking cessation in primary health care.

BackgroundSmoking cessation is beneficial for our health at any point in life, both in healthy people and in people already suffering from a smoking-related disease. Any help to quit smoking can produce considerable benefits for Public Health. The purpose of the present study is to evaluate the efficacy of the CO-oximetry technique together with brief advice in smoking cessation, in terms of reduction of the number of cigarettes or in the variation of the motivation to quit smoking at month 12 compared with brief advice alone.Methods/DesignRandomised, parallel, single-blind clinical trial in a primary health care setting in Majorca (Spain). Smokers in contemplation or pre-contemplation phase will be included in the study. Exclusion criteria: Smokers in preparation phase, subjects with a terminal illness or whose health status does not allow them to understand the study or complete the informed consent, and pregnant or breastfeeding women. The subjects will be randomly assigned to the control group (CG) or the intervention group (IG). The CG will receive brief advice, and the IG will receive brief advice together with a measurement of exhaled CO. There will be follow-up evaluations at 6 and 12 months after inclusion. 471 subjects will be needed per group in order to detect a difference between groups ≥ 5%. Primary outcome: sustained smoking cessation (at 6 and 12 months) confirmed by urine cotinine test. Secondary outcomes: point smoking cessation at 6 and 12 months both confirmed by urine cotinine analysis and self-reported, reduction in cigarette consumption, and variation in phase of smoking cessation.DiscussionCO-oximetry is an inexpensive, non-invasive, fast technique that requires little technical training; making it a technique for risk assessment in smokers that can be easily applied in primary care and, if proven effective, could serve as a reinforcement aid in smoking cessation intervention activities.Trial RegistrationCurrent Controlled Trials ISRCTN67499921