Context Of Health Research Articles

Advancements in Rapid and Affordable Diagnostic Testing for Respiratory Infectious Diseases: Evaluation of Aptamer Beacon Technology for Rapid and Sensitive Detection of SAR-CoV-2 in Breath Condensate.

The demand for rapid and efficient diagnostic point-of-care tests for respiratory infectious diseases has become increasingly critical in the current landscape. The emphasis on accessibility has been underscored over the past year, making it crucial to have biological components that exhibit fast and accurate kinetics. The foundation for precise, swift, and effective testing relies on the availability of highly responsive biological agents. Two published aptamer DNA sequences designated Song and MSA52 and their truncated internal stem-loop structures were studied for their potential to serve as aptamer beacons for rapid COVID detection. The candidate beacons were covalently labeled with Atto 633 dye attached to their 5' ends and Iowa Black quencher attached to their 3' ends. The whole aptamer structures exhibited the greatest fluorescence signal intensities and higher fluorescence background than their truncated internal stem-loop beacon structures suggesting that the distance between fluorophores and quenchers was greater for the whole aptamer beacon candidates versus the isolated stem-loop structures. Beacon candidates were tested against two heat- or gamma radiation-killed SARS-CoV-2 Washington 1/2020 virus samples and three different COVID spike (S) proteins to test their effectiveness. Despite the higher background fluorescence, the whole aptamer beacons showed better signal-to-noise ratios and were selected for further investigation. Limit of detection (LOD) studies revealed that both the whole Song and whole MSA52 aptamer beacon candidates had a LOD of 9.61 × 103 genome equivalents in phosphate-buffered saline using the red channel of a Promega Quantus™ fluorometer which correlated well with confirmatory spectrofluorometry. Cross-reactivity studies using numerous COVID variants, related coronaviruses, and other common respiratory pathogens suggested greater COVID selectivity for the whole MSA52 versus the whole Song aptamer beacon candidate, indicating promise for specific COVID detection. Importantly, both whole aptamer beacon candidates exhibited very rapid "bind and detect" fluorescence increases within the first 1-2min of mixing the beacons with killed SARS-CoV-2 viruses in 100µl samples. Overall, this work illustrates the strong potential for aptamer beacons for rapid, on-site detection and presumptive diagnosis of COVID in breath condensates or other small liquid samples. This research highlights the strong potential of aptamer beacons for addressing the need for fast and convenient diagnostic tools in global health contexts, especially in resource-limited settings.

Neutrophils' Contribution to Periodontitis and Periodontitis-Associated Cardiovascular Diseases.

Neutrophils represent the primary defense against microbial threats playing a pivotal role in maintaining tissue homeostasis. This review examines the multifaceted involvement of neutrophils in periodontitis, a chronic inflammatory condition affecting the supporting structures of teeth summarizing the contribution of neutrophil dysfunction in periodontitis and periodontal-related comorbidities. Periodontitis, a pathological condition promoted by dysbiosis of the oral microbiota, is characterized by the chronic inflammation of the gingiva and subsequent tissue destruction. Neutrophils are among the first immune cells recruited to the site of infection, releasing antimicrobial peptides, enzymes, and reactive oxygen species to eliminate pathogens. The persistent inflammatory state in periodontitis can lead to aberrant neutrophil activation and a sustained release of proinflammatory mediators, finally resulting in tissue damage, bone resorption, and disease progression. Growing evidence now points to the correlation between periodontitis and systemic comorbidities. Indeed, the release of inflammatory mediators, immune complexes, and oxidative stress by neutrophils, bridge the gap between local and systemic immunity, thus highlighting neutrophils as key players in linking periodontal inflammation to chronic conditions, including cardiovascular diseases, diabetes mellitus, and rheumatoid arthritis. This review underscores the crucial role of neutrophils in the pathogenesis of periodontitis and the complex link between neutrophil dysfunction, local inflammation, and systemic comorbidities. A comprehensive understanding of neutrophil contribution to periodontitis development and their impact on periodontal comorbidities holds significant implications for the management of oral health. Furthermore, it highlights the need for the development of novel approaches aimed at limiting the persistent recruitment and activation of neutrophils, also reducing the impact of periodontal inflammation on broader health contexts, offering promising avenues for improved disease management and patient care.

The effect of brief exposure to virtual nature on mental wellbeing in adolescents

Adolescence is a time of multiple transitions and a vulnerability period for mental health difficulties. There are many barriers to the treatment of mental health conditions which is one reason for developing alternatives to help improve efficacy in treatment and prevention. One approach is to use nature-based interventions (NBIs) to improve mental wellbeing. In this experimental proof-of-principle intervention study, we randomly allocated a sample of adolescents to brief exposure (6 min) to either a virtual woodland nature video or a busy train journey and tested the effect on mental wellbeing. Results showed beneficial effects in the nature condition on several self-reported outcomes including stress, relaxation, affect, mood, attention, nature connection and nature spirituality. The intervention was mainly acceptable and feasible to do suggesting that overall brief virtual nature interventions may have utility in a range of mental health contexts for adolescents including as self-help universal or targeted prevention strategies, adjunct to psychological therapy and as preparation for more intensive NBIs. Additionally, brief virtual nature interventions support accessibility for those who may be limited on time, unable to access real-life nature or who may be more biophobic.

Changing the global obesity narrative to recognize and reduce weight stigma: A position statement from the World Obesity Federation.

Weight stigma, defined as pervasive misconceptions and stereotypes associated with higher body weight, is both a social determinant of health and a human rights issue. It is imperative to consider how weight stigma may be impeding health promotion efforts on a global scale. The World Obesity Federation (WOF) convened a global working group of practitioners, researchers, policymakers, youth advocates, and individuals with lived experience of obesity to consider the ways that global obesity narratives may contribute to weight stigma. Specifically, the working group focused on how overall obesity narratives, food and physical activity narratives, and scientific and public-facing language may contribute to weight stigma. The impact of weight stigma across the lifespan was also considered. Taking a global perspective, nine recommendations resulted from this work for global health research and health promotion efforts that can help to reduce harmful obesity narratives, both inside and outside health contexts.

Natural language processing (NLP) aided qualitative method in health research

Qualitative data analysis is produced frequently in healthcare settings, which is a time-consuming and skilled analytic task. The use of qualitative research findings in clinical settings takes years, which is sometimes obsolete knowledge as the health context is dynamic. Artificial Intelligence (AI)-based qualitative data analysis might present with rapid analysis of text-based data in real-time, thereby empowering qualitative researchers to expedite their analysis and facilitate timely use of the research findings. We tested an AI-based method to complement the manual analysis of text-based data from the verbatim transcripts of seven mall managers’ interviews. First, we prepared text data into a machine-calculable format and employed BERT model to extract sentence-level features in our case. Second, we implement TF-IDF-based keywords mining techniques to extract the main candidate themes from the interview transcripts to support text-based analysis, including: 1) primary cluster detection algorithm, and 2) keyword extraction algorithm. The extracted core themes provide qualitative researchers with a more comprehensive overview of the qualitative data. Most of the sentences clustered in meaningful short topics or sentences carrying independent and clear information. The extracted topics and clustered sentences reduced qualitative researchers’ workload by condensing and identifying meaningful concepts and naming them. This method combining contextualized word embeddings, unsupervised clustering, and keyword extraction techniques can significantly reduce the overall workload and time consumed in qualitative research using conventional methods.

Understanding collaborative and coordinated care in a mental health and well-being context: Essential elements for effective service integration.

Multiple system reforms in Australia, including the National Disability Insurance Scheme (NDIS), are changing mental health (MH) and disability-related service provision, whilst policy drivers continue to require service integration. This has necessitated service providers discovering new ways of working collaboratively to achieve an integrated model of care. This qualitative study examined what does and does not work to support collaborative and coordinated care (CCC), as essential components of service integration. The study sample (n = 59) included four cohorts: health and community service leaders (n = 16), staff (n = 23); MH service consumers with complex needs (n = 10), and MH carers (n = 10). Thematic analysis from interviews was applied to data from each cohort to identify overarching themes that described the lived experience of current CCC delivery. COREQ and EQUATOR guidelines were applied to reporting the findings. Themes emphasized CCC is enabled by the development and sustainability of positive working relationships, and depth of knowledge across health and community services. Unnavigable service systems, stigmatization, perceived power differentials, multiple and rapid service reforms and Fee-For-Service (FFS) models provide significant barriers to CCC. Recommendations include the need for accessible service navigation, consumer-friendly service environments, a stable workforce, standardization of knowledge across sectors, outcome measures and funding attached to CCC as part of a raft of potential changes.

A Qualitative Study of the Psychosocial, Physical and Spiritual Benefits and Challenges Experienced by Psychiatric Patients Engaging Community Mental Health Services

Background Mental illness generates feelings of shame, low self-esteem, isolation, and hopelessness which affect wellbeing and quality of life. Mental health care practitioners, therefore, need to support their clients to improve their quality of life. Despite an increasing awareness of the importance of spirituality in mental health contexts, a religiosity gap exists in the difference in the value placed on spirituality and religion. This may be due to a lack of understanding about the complex ways people connect with spirituality within contemporary society and mental health contexts and can result in people's spiritual needs being neglected or dismissed within clinical practice (K. Milner et al., 2020). Additionally, mental illness may cause a variety of psychosocial problems such as decreased quality of life of the patient and their family members as well as increased social distance for the patient and the family caring for the patient. Psychosocial challenges are enhanced by the stigma attached to mental illness, which is a problem affecting not only the patient but also the family. Coping mechanisms for dealing with mentally ill patients differ from one family to another for a variety of reasons (Kakuma R et al., 2010). Objective: The aim of this study was to explore the contribution of community mental healthcare services to the wellbeing of persons with a history of mental illness using the Betty Ferrell’s Quality of Life (QoL) model. Methods A qualitative research approach was adopted, using exploratory descriptive design to describe the experiences of psychiatric patients engaging community mental health services. An in-depth interview was conducted using Betty Ferrell’s Model as a guiding framework. Each interview lasted about an hour. All interviews were audiotaped, transcribed, and the content analyzed thematically. A purposive sampling method was used to select 11 participants who participated in a face-to-face in-depth interview. Responses from the interviews were transcribed verbatim and analysed using the thematic content analysis approach. Results The findings from the study revealed the important and valuable contribution of community mental health nursing services to the quality of life and wellbeing of persons with mental illness in all spheres of their functioning. The main themes and sub-themes on how community mental healthcare services impact the wellbeing of persons with history of mental illness were Spiritual wellbeing (‘hope’, ‘transcendence’, ‘positive changes’), Social wellbeing (‘good social interaction’, ‘good relationship with family’, ‘good relationship with community members’, ‘good relationship with church members’), Psychological wellbeing (‘perception of overall quality of life’, ‘anxiety/depression’, cognition/attention’, assertiveness’), and Physical wellbeing (‘adherence to medication regimen’, overall physical health’, functional ability’, appetite’). Community mental health nurses have also been instrumental in promoting the social wellbeing of people with history of mental illness. Improvement in the spiritual lives and religious activities of the clients through the intervention of the nurses helped them to find some purpose and meaning in life. Counselling, reassurance, encouragement, and education of clients by the nurses provided some relief from their anxieties and depression and promoted client compliance with prescribed treatment regimen. Conclusion Both theoretical and empirical literature reviewed show that social and emotional support for persons living with mental illness, or with a history of mental illness, are important to their quality of life. The support given within the community is invaluable. Thus, community mental health care services span the well-being in the domains of physical, social, spiritual, and psychological functioning.

Efecto de la suplementación con mioinositol en la estructura fisicoquímica de la carga viral en el alimento para gatos contaminados con SARS–CoV–2 mediante la simulación de estornudos

The study was carried to investigate the effect of myo–inositol supplementation on feed physicochemical structure and viral load of dry cat food contaminated with inactive SARS–CoV–2 by simulating sneezing. The most natural infection of severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2) in animals is related to close contact with their owners with COVID–19 which is handling, taking care and feeding them. SARS–CoV–2 can survive on food, fomites and surfaces for extended periods related to environmental conditions. Many natural feed additives and supplements have been a candidate in recent antiviral treatment strategies against COVID–19. In this study, myo–inositol which is permitted in animal nutrition was used at different concentrations (0, 12.5, 25 and 50 mg·100 g-1 cat food) and conditions (22°C at room temperature and 4°C in the refrigerator) to investigate its effects on feed physicochemical structure and viral load of dry cat food contaminated with inactive SARS–CoV–2 by simulating sneezing. For the interactions between myo–inositol, feed structure and viral load, dry matter, moisture, water absorption index (WAI), water solubility index (WSI), pH and virus gene copy (GC) by RT–qPCR were measured. As only storage temperature affected both WAI and WSI as expected, myo–inostol supplementation dose–dependently decreased gene copy in dry cat food (IC50:366.4–581.5 mg·100 g-1 cat food) at 22°C storage temperature. Virus GC did not correlate with the dry matter, moisture content, pH and WAI after the 30 min contact time (except WSI). In conclusion, myo–inositol as a feed additive might have the potential to control serious viral infections such as COVID–19 for human–animal interactions in a One–Health context.

Mechanistic prospective and pharmacological attributes of quercetin in attenuation of different types of arthritis.

Arthritis is a frequent autoimmune disease with undefined etiology and pathogenesis. Scientific community constantly fascinating quercetin (QUR), as it is the best-known flavonoid among others for curative and preventive properties against a wide range of diseases. Due to its multifaceted activities, the implementation of QUR against various types of arthritis namely, rheumatoid arthritis (RA), osteoarthritis (OA), gouty arthritis (GA) and psoriotic arthritis (PsA) has greatly increased in recent years. Many research evidenced that QUR regulates a wide range of pathways for instance NF-κB, MAK, Wnt/β-catenine, Notch, etc., that are majorly associated with the inflammatory mechanisms. Besides, the bioavailability of QUR is a major constrain to its therapeutic potential, and drug delivery techniques have experienced significant development to overcome the problem of its limited application. Hence, this review compiled the cutting-edge experiments on versatile effects of QUR on inflammatory diseases like RA, OA, GA and PsA, sources and bioavailability, therapeutic challenges, pharmacokinetics, clinical studies as well as toxicological impacts. The use of QUR in a health context would offer a tearing and potential therapeutic method, supporting the advancement of public health, particularly, of arthritic patients worldwide.

An evidence-informed policymaking (EIPM) competency profile for the Brazilian Health System developed through consensus: process and outcomes

BackgroundEvidence-informed policymaking (EIPM) requires a set of individual and organizational knowledge, skills and attitudes that should be articulated with background factors and needs. In this regard, the development of an EIPM competency profile is important to support the diagnosis, planning and implementation of EIPM.PurposeTo present the process and outcomes of the development of an EIPM competency profile by an expert committee, to be applied in different contexts of the Brazilian Health System.MethodsA committee of experts in EIPM shared different views, experiences and opinions to develop an EIPM competency profile for Brazil. In six consensus workshops mediated by facilitators, the committee defined from macro problems to key actions and performances essential for the competency profile. The development steps consisted of: (1) Constitution of the committee, including researchers, professionals with practical experience, managers, and educators; (2) Development of a rapid review on EIPM competency profiles; (3) Agreement on commitments and responsibilities in the processes; (4) Identification and definition of macro problems relating to the scope of the competency profile; and (5) Outlining of general and specific capacities, to be incorporated into the competency profile, categorized by key actions.ResultsThe development of the EIPM competency profile was guided by the following macro problems: (1) lack of systematic and transparent decision-making processes in health policy management; (2) underdeveloped institutional capacity for knowledge management and translation; and (3) incipient use of scientific evidence in the formulation and implementation of health policies. A general framework of key actions and performances of the EIPM Competency Profile for Brazil was developed, including 42 specific and general key actions distributed by area of activity (Health Management, Scientific Research, Civil Society, Knowledge Translation, and Cross-sectional areas).ConclusionsThe competency profile presented in this article can be used in different contexts as a key tool for the institutionalization of EIPM.

Rén qíng wèi (‘flavour of human feelings’) in the pragmeme of delivering Covid-19 directives

Previous studies on advice-giving in health contexts are largely based on face-to-face data or on issues related to target groups of individuals with specific health conditions. However, advice delivered in response to the coronavirus pandemic constitutes an unprecedented health context, as such advice is provided for the benefit of every individual in society. Based on the data of 30 1-min videos produced by the Taiwan Centers for Disease Control, this study investigates how directives are delivered and how rén qíng wèi (‘flavour of human feelings’), a Chinese term that encapsulates a composite of warm feelings, is manifested in the verbal delivery of Covid-19 directives. By conceptualising the delivery of Covid-19 directives as a pragmeme, this study investigates how the pragmeme is realised in Taiwan and examines how rén qíng wèi, an aggregate of culturally valued affectivity, is intertwined with directives, thereby strengthening the affective and cultural dimensions of pragmeme theory.

Angry Content for Angry People: How Anger Appeals Facilitate Health Misinformation Recall on Social Media

ABSTRACT Social media is often viewed as a breeding ground for misinformation, given the anger-laden nature of its content. Despite the persuasiveness of anger and misinformation on social media, little is known about how misinformation surges in power when users are exposed to misinformation-related anger appeals and/or misinformation-unrelated (i.e. ambient) anger. Employing two online experiments across different health contexts, the studies test mechanisms of anger appeals and their individual and combined effects on misinformation recall. Specifically, Study 1 (N = 210) examines the interaction between a misinformation-related anger appeal and issue relevance, illustrating that issue relevance increased the recall of emotion-neutral appeals but did not influence recall among those exposed to the misinformation-related anger appeal. Expanding on this finding, Study 2 (N = 400) investigates a three-way interaction between exposure to a misinformation-related anger appeal, ambient anger, and issue relevance. The findings underscore the role of ambient anger in contributing to misinformation recall for users with high issue relevance and those exposed to misinformation-relevant anger appeals. These results further highlight the complex and conditional influence of anger appeals on misinformation recall.

Conceptualizing ethics positions of health and fitness managers; an empirical investigation in Greece

Abstract. This research aim was to examine the ethical viewpoints of health and fitness managers in Greece. To achieve this, an adapted version of the Ethics Position Questionnaire (EPQ) (Forsyth, 1980) was employed. Additionally, the study sought to determine whether managers of these fitness centers leaned more towards idealism or relativism in their ethical perspectives. A group of 249 health and fitness managers participated in this study and completed Forsyth's original EPQ questionnaire included a total of 20 variables, with 10 assessing Idealism, and 10 evaluating Relativism. The EPQ was translated into Greek and adapted to suit the specific context of the Greek health and fitness industry, following multiple pilot studies. Both confirmatory and exploratory factor analyses were conducted, resulting in a 12-item questionnaire with two distinct factors. The modified EPQ demonstrated strong internal consistency and showed convergent validity with related constructs. Furthermore, the categorization of normative procedures into types suggested that health and fitness managers in Greece held varying ethical positions. Some leaned towards a more absolute ethical approach, while others took into account situational factors in their ethical considerations. Investigating the ethical perspectives of health and fitness managers can provide valuable insights for developing ethical codes of conduct and tailored educational initiatives within this sector. Key Words: business ethics, health & fitness, managers, Ethics Position Questionnaire (EPQ)

A - 75 Neuropsychological Consequences of Anoxic Encephalopathy Pursuant to Myocardial Infarction.

Myocardial infarctions (MI) often result in irreversible muscle damage to the heart and difficulty returning to daily activities. While the physical consequences of acute cardiac events are well documented in the medical literature (Lesperance et al., 1996), there is less research identifying the cognitive, emotional, and behavioral consequences of MI (Brink et al., 2008) particularly when complicated by anoxia and unresponsiveness. We present a case study of a 54-year-old right-handed male with 12years of education referred for neuropsychological assessment pursuant to mental status changes following a MI with an estimated 25-30minutes of unresponsiveness and subsequent diagnosis of anoxic encephalopathy, supported by neuroimaging, which is also positive for a 4mm pituitary tumor. Neuropsychological assessment revealed difficulties with cognitive efficiency, sequencing, language production, phonemic fluency, and memory. Performance was also inconsistent with age- and education-weighted norms, and therefore did not reflect a normal aging profile. An objective psychological inventory (PAI) revealed negative self-evaluation, a focus on health matters, acute stress, and substance concerns. Additionally, an endorsement of social isolation, discomfort in social interactions, and a readiness to express anger verbally was indicated. Findings supported diagnosis of cognitive impairment associated with anoxic brain injury from above noted MI. This case provides an example of the neuropsychological consequences of anoxic encephalopathy from MI on cognitive, emotional and behavioral functioning. It also supports the need for awareness of bodily health within the context of overall cognitive health. It emphasizes the benefits of integrating physiological and neurocognitive symptoms when conceptualizing patients with cardiac arrest.

A Manual Therapy in Need of a Manual: Conceptualizing and Comparing Existing Vocal Massage Protocols and Their Use in the Treatment of Voice Problems

ABSTRACT Vocal manual therapy (VMT) is a heterogenous term used to describe a variety of touch-based approaches to voice rehabilitation and maintenance. VMT aims to use manipulation, massage, and reposturing to change how the voice sounds and feels. Since first described in 1990, there has been a proliferation in the use of VMT in the treatment of voice problems, with increasing interest in its usefulness within clinical and non-clinical voice settings. This forum article presents a narrative review of 42 studies investigating the use of VMT in a vocal health context. The aim was to identify the theoretical orientations of VMT protocols, draw links between the techniques employed in their administration, and highlight similarities and differences in use of language across VMT protocols. Relevant articles for review were identified via informal literature search using forward and backward citation screening and then described using narrative synthesis. Theoretical orientations were broad and influenced by speech pathology research as well as Finnish massage, naprapathy and yoga. 26 ostensibly different protocols were identified across the 42 studies, with considerable variation in protocol length and frequency. Language was highly varied across protocols. The forum article therefore advocates for greater shared understanding in VMT research and practice.

A Perspective on High-Intensity Interval Training for Performance and Health

Interval training is a simple concept that refers to repeated bouts of relatively hard work interspersed with recovery periods of easier work or rest. The method has been used by high-level athletes for over a century to improve performance in endurance-type sports and events such as middle- and long-distance running. The concept of interval training to improve health, including in a rehabilitative context or when practiced by individuals who are relatively inactive or deconditioned, has also been advanced for decades. An important issue that affects the interpretation and application of interval training is the lack of standardized terminology. This particularly relates to the classification of intensity. There is no common definition of the term “high-intensity interval training” (HIIT) despite its widespread use. We contend that in a performance context, HIIT can be characterized as intermittent exercise bouts performed above the heavy-intensity domain. This categorization of HIIT is primarily encompassed by the severe-intensity domain. It is demarcated by indicators that principally include the critical power or critical speed, or other indices, including the second lactate threshold, maximal lactate steady state, or lactate turnpoint. In a health context, we contend that HIIT can be characterized as intermittent exercise bouts performed above moderate intensity. This categorization of HIIT is primarily encompassed by the classification of vigorous intensity. It is demarcated by various indicators related to perceived exertion, oxygen uptake, or heart rate as defined in authoritative public health and exercise prescription guidelines. A particularly intense variant of HIIT commonly termed “sprint interval training” can be distinguished as repeated bouts performed with near-maximal to “all out” effort. This characterization coincides with the highest intensity classification identified in training zone models or exercise prescription guidelines, including the extreme-intensity domain, anaerobic speed reserve, or near-maximal to maximal intensity classification. HIIT is considered an essential training component for the enhancement of athletic performance, but the optimal intensity distribution and specific HIIT prescription for endurance athletes is unclear. HIIT is also a viable method to improve cardiorespiratory fitness and other health-related indices in people who are insufficiently active, including those with cardiometabolic diseases. Research is needed to clarify responses to different HIIT strategies using robust study designs that employ best practices. We offer a perspective on the topic of HIIT for performance and health, including a conceptual framework that builds on the work of others and outlines how the method can be defined and operationalized within each context.

Social media use and paediatric practice: Hippocratic help, hype or harm?

Social media is increasingly a part of our personal and professional life and is here to stay. Here, I reflect on issues surrounding the use of social media (SMU) in the digital health context by clinicians inAustralian paediatric health care. I aim to briefly highlight some inherent multifactorial and contextual ethical considerations which mainly relate to professionalism; including boundaries, obligations to patients and families within the therapeutic alliance, and balancing the help, hype and harm of SMU in clinical practice. I conclude that digital health and SMU are ubiquitous, and can be beneficial if used circumspectlywith Hippocratic principles that have beenupdated for the modern era and are grounded in ancient moral codes. Unfettered SMU however, without adherence to ethical and legal guidelines is problematic, and may expose patients, families and clinicians to significant risk of harm and moral vulnerability. Justifiable, explicit, consistent and regularly reviewed boundaries, both professional and personal, are ethically advisable. These should reflect, and adapt to, the rapidly evolving nature of social media as imprudent digital health and SMU without proportionate limits, may undermine still relevant Hippocratic tenets, and the primacy of doing no harm.

Microglia and Astrocytes in Amyotrophic Lateral Sclerosis: Disease-Associated States, Pathological Roles, and Therapeutic Potential.

Microglial and astrocytic reactivity is a prominent feature of amyotrophic lateral sclerosis (ALS). Microglia and astrocytes have been increasingly appreciated to play pivotal roles in disease pathogenesis. These cells can adopt distinct states characterized by a specific molecular profile or function depending on the different contexts of development, health, aging, and disease. Accumulating evidence from ALS rodent and cell models has demonstrated neuroprotective and neurotoxic functions from microglia and astrocytes. In this review, we focused on the recent advancements of knowledge in microglial and astrocytic states and nomenclature, the landmark discoveries demonstrating a clear contribution of microglia and astrocytes to ALS pathogenesis, and novel therapeutic candidates leveraging these cells that are currently undergoing clinical trials.

Clinician motivational interviewing skills in 'simulated' and 'real-life' consultations differ and show predictive validity for 'real life' client change talk under differing integrity thresholds.

Accurate and reliable assessment of clinician integrity in the delivery of empirically supported treatments is critical to effective research and training interventions. Assessment of clinician integrity can be performed through recording simulated (SI) or real-life (RL) consultations, yet research examining the equivalence of these data is in its infancy. To explore the strength of integrity assessment between SI and RL samples in Motivational Interviewing (MI) consultations, this article examines whether Motivational Interviewing Treatment Integrity (MITI) assessments differ between SI and RL consultations and reviews the predictive validity of SI and RL MI skills categorisations for RL client response language. This study first compared MITI coding obtained in SI and RL consultations for 36 veterinary clinicians. Multilevel models of 10 MITI behaviour counts and four MITI global scores were run using MLwiN 3.02 to assess if a significant difference existed between SI and RL MITI data, with consultation within clinician within cohort (A and B) as nested random effects. Second, we investigated the effect of SI and RL MI skills groupings on rate of RL client response talk using three multivariable regression models. Two Poisson regression models, with random intercepts for farm and veterinarian and offset for number of minutes of the recordings, were estimated in the statistical software R using the package glmmTMB for the two response variables Change Talk and Sustain Talk. A logistic regression model, with the same random intercepts, with the response variable Proportion Change Talk was also estimated using the same package. Veterinary clinicians were less MI consistent in RL consultations, evidenced through significantly lower global MITI Cultivating Change Talk (p < 0.001), Partnership (p < 0.001) and Empathy (p = 0.003) measures. Despite lower objective MI skills groupings in RL consultations, ranking order of veterinary clinicians by MI skills was similar between contexts. The predictive validity of SI and RL MI skills groupings for RL client Change Talk was therefore similar, with significantly more RL client Change Talk associated with veterinarians categorised in the highest grouping ('moderate') in both SI (p = 0.01) and RL (p = 0.02) compared to untrained veterinarians in each respective context. Findings suggest SI and RL data may not be interchangeable. Whilst both data offer useful insights for specific research and training purposes, differing contextual MI skills thresholds may offer a more equitable assessment of clinician RL client-facing MI integrity. Further research is needed to explore the applicability of these findings across health contexts.

Integrating Social Care into Healthcare: A Review on Applying the Social Determinants of Health in Clinical Settings.

Despite the substantial health and economic burdens posed by the social determinants of health (SDH), these have yet to be efficiently, sufficiently, and sustainably addressed in clinical settings-medical offices, hospitals, and healthcare systems. Our study contextualized SDH application strategies in U.S. clinical settings by exploring the reasons for integration and identifying target patients/conditions, barriers, and recommendations for clinical translation. The foremost reason for integrating SDH in clinical settings was to identify unmet social needs and link patients to community resources, particularly for vulnerable and complex care populations. This was mainly carried out through SDH screening during patient intake to collect individual-level SDH data within the context of chronic medical, mental health, or behavioral conditions. Challenges and opportunities for integration occurred at the educational, practice, and administrative/institutional levels. Gaps remain in incorporating SDH in patient workflows and EHRs for making clinical decisions and predicting health outcomes. Current strategies are largely directed at moderating individual-level social needs versus addressing community-level root causes of health inequities. Obtaining policy, funding, administrative and staff support for integration, applying a systems approach through interprofessional/intersectoral partnerships, and delivering SDH-centered medical school curricula and training are vital in helping individuals and communities achieve their best possible health.