bluuebunny/crossref_metadata_2025 huggingface dataset:
S09-4: ‘Equality in the Field’
Authors: Nugent Seamus
Published: September 2024

Purpose

Sport participation and physical activity have a positive influence on the health of young people (Doull et al. 2018). However, in Irish schools 73% (n = 788) of LGBTQ+ students report feeling unsafe, while 77% have experienced verbal harassment based on their gender expression or sexual orientation (BeLonG, 2019). A consultation for strategy development by Kilkenny Recreation & Sports Partnership (KRSP) found that as an organisation it needs to improve its engagement with for the LGBTQ+ community and to develop practical support and training for sports organisations.

Methods

A mixed methods study was conducted in November 2022 which used a transformative queer framework supported by gender affirmation theory. It focussed on LGBTQ+ groups of students, secondary school students and university students. In total 42 LGBTQ+ students attended focus groups and 41 completed a survey.

Results

The built environment, especially changing rooms and toileting facilities, were deemed to be a major barrier to LGBTQ+ participation in sport and physical activity. Other findings highlighted the need for non-discriminatory policies, inclusive language and staff and volunteer training. Finally, it emerged that there is a need for an overall respectful, inclusive culture, one where bullying and harassment are not tolerated and where diverse gender expression and sexual identity is acceptable.

Conclusion

It is critical that policymakers and service providers understand the factors which influence sport participation among the LGBTQ+ youth community. The findings underscore the importance of considering the unique barriers LGBTQ+ youth face during sport participation and the need for support/training to be provided for parents, coaches, educators, and sports providers. Considering that many of the study recommendations are low cost or no cost, the main challenge will be adopting appropriate practices which will support and guide intervention development.

KRSP are currently researching the awareness and uptake of training in LGBTQ+ theory and current / correct terminology by sports clubs and facilities in the Kilkenny/Carlow area. Following this they will develop, disseminate, and evaluate the use of a newly developed toolkit by sports clubs and sporting facilities in the study area.

Support/Funding Source

Kilkenny Local Sports Partnership, LinkAge Consultancy
S11-1: How to reach women in difficult life situations and encourage their participation in physical activity: Insights from urban and rural areas
Authors: Till Maike , Abu-Omar Karim , Ziemainz Heiko
Published: September 2024

Purpose

The community-based participatory research project “BIG” aims to empower socially disadvantaged women (e.g. single-mothers, unemployed women) to engage in physical activity (PA) and exercise. These women face barriers to exercise, such as high registration fees, limited childcare options, and culturally insensitive programs. This study explored various approaches to reaching these women and compared strategies between rural and urban areas.

Methods

Over the last three years, two cities and three rural districts in Bavaria, Germany, have adopted the BIG project, previously implemented in 17 cities. As part of the intervention-study, project coordinators participated in annual individual interviews with a specific focus on reaching women. A total of 11 interviews were transcribed and analyzed using an inductive qualitative content-analysis, assisted by MAXQDA software, to address the research objective.

Results

Preliminary results suggest that women facing difficult life situations (e.g., being unemployed, single mothers or from a different cultural background) are more readily reached in urban settings compared to rural areas. This can be attributed to the better-equipped structures and networks present in urban areas. Cities usually have specific meeting points, such as women's centers, support centers for immigrants and asylum seekers, or integration officers. In rural areas, the engagement of individual volunteers is crucial, especially leaning on the efforts of pivotal figures within each community. These individuals contribute their networks and expertise to support these initiatives, having earned the trust of the citizens. While individual 'champions' are influential in both rural and urban areas, their efforts and the trust they establish play a more significant role in rural areas.

Conclusions

The study results highlight the necessity for distinct approaches, particularly in rural areas. Subsequent initiatives should prioritize devising methods to implement projects in these regions and employ strategies to reach women facing difficult life situations, especially those residing away from existing services.

Support/Funding Source

This study was funded by the GKV-Bündnis for health.
S11-2: Reaching and recruiting young people experiencing homelessness for physical activity interventions: Challenges, opportunities, and recommendations
Authors: Thomas Jennifer , Crone Diane , Bowes Nicola , Thirlaway Katie , Meyers Robert W , Mackintosh Kelly A
Published: September 2024

Purpose

There is a growing body of evidence to suggest that physical activity-based interventions may be effective for engagement, psychological outcomes, and behaviour change of young people experiencing homelessness (YPEH). Nonetheless, challenges associated with reaching and recruiting this marginalised population are frequently reported owing to social isolation, lack of trust, and a high prevalence of poor mental health. This study sought to explore common barriers to recruitment, and identify potential strategies through which these may be overcome.

Methods

Three 8-week physical activity interventions were delivered to groups of between 4 and 12 YPEH. Following each intervention, qualitative data was collected through a series of interviews with implementers (sports coaches; n = 5) and support staff (n = 3), and three focus groups with participants (n = 17). Documented feedback, such as informal correspondence with staff, were used to provide further insights. Data were transcribed verbatim and analysed using a mixed inductive/deductive thematic approach to identify multi-level challenges and opportunities, and comprehensively address the research aims.

Results

Multiple barriers and opportunities to the reach and recruitment of YPEH were identified across organisational, individual, and intervention levels. Challenges included limited staffing and organisational resources, negative experiences of participants, and sub-optimal intervention design and materials. Enablers included co-production with stakeholders, organisational staff champions, participant incentives, appropriate materials, and an active outreach recruitment strategy.

Conclusions

Overcoming challenges associated with reaching and recruiting marginalised groups for physical activity interventions requires consideration of multi-level barriers from the early stages of intervention development. While the enablers identified are concurrent with those reported across wider literature, future research should focus on how these can be embedded in a co-productive manner involving all stakeholders, throughout the research process.

Support/Funding Source

Knowledge Economy Skills Scholarships (KESS 2); European Social Research Council Postdoctoral Fellowship Programme.
S14-4: Designing a physical activity pathway in healthcare model for Irish Health Services
Authors: O’Brien Sarah , Casey Blathin , Cotter Eimear
Published: September 2024

Background

There is strong evidence for health benefits of regular physical activity (PA) for preventing non-communicable diseases and reducing risk factors as well as improving mental, physical, and emotional health for those living with chronic diseases. There is not a consistent, coherent mechanism to connect patients in primary care with supports and services to be more physically active currently within the Irish public health service.

Purpose

To design a physical activity pathway, and identify the supporting infrastructure required to enable implementation across the Irish public health system, with a particular focus on primary care.

Methods

Using HSE Change Management Guide, the HSE Healthy Eating Active Living Programme commenced a project to co-design a pathway and identify essential infrastructure to support implementation of the pathway across the Irish public health system. Stakeholders engaged in the co-design process include health professionals, health service planners and managers, Local Sports Partnerships, Sport Ireland as well as the public who are potential service users.

Results

A range of methods including interviews, focus groups and workshops were used to gather insights from stakeholders and potential service users to inform the service design. The COM-B model was used as an underpinning behaviour change theoretical framework to analyse the insights including the use of APEASE criteria to prioritise components for the service design.

Conclusions

Establishing a physical activity pathway in healthcare model in a public health service is a complex process. Using a structured change management process, with a strong focus on stakeholder engagement to facilitate co-design may increase success of implementation.

Practical implications

This work will result in a coherent, consistent, resourced process to connect service users in the Irish public health service with appropriate community based, publicly funded physical activity opportunities.

Funding

The Health Services Executive, Ireland
S15 Promoting Physical Activity and Health in Sports Clubs: the what, the why and the how!
Authors: Van Hoye Aurélie , Seghers Jan
Published: September 2024

Purpose

The symposium will discuss the relationship between health and sport, to enlighten current configurations, as well as on how to foster the relationships between the two concepts.

Methods

Four presentations are foreseen in the symposium. First, Susanna Geidne (Örebro University, Sweden) will tackle the what by introducing four core concepts (health promotion as an outcome of sport, in sport, through sport and health promoting sport), their stakes and challenges in terms of application. Second, Jenifer Gothilander (Mälardalen University, Sweden) will explore the why by describing participations patterns in organised and unorganised sport among adolescents in Sweden. The two last presentation will highlight the how of physical activity and health promotion in organised sport. Third, Catherine O’Sullivan (World Athletics, Monaco) will showcase how physical activity is fostered among World Athletics activities. Fourth, Kevin Barros (Université de Lorraine, France) will present results of a literature review on coaches’ health promotion skills, strategies and training needs.

Results

Participants will learn that health promotion in sport is not given and better understand the difference between fostering health through sport and being health promoting, how to adapt policies to tackle participants trends, how to best organise sport events and activities to foster active lifestyle and discover different strategies that coaches adopt to promote health based on their communication, motivation or management skills.

Conclusion

Finally, Aurélie Van Hoye (University of Limerick, Ireland) and Jan Seghers (Katholieke Universiteit Leuven, Belgium) will engage the conversation with the audience on how to better root physical activity and health promotion by taking organised sport contexts into account.
S15-1: Sports clubs as health promotion settings: From physical activity to sustainable sport - a question of how!
Authors: Geidne Susanna , Ericson Helena , Quennerstedt Mikael , Van Hoye Aurélie
Published: September 2024

Purpose

The concepts of public health, health and health promotion have been used for decades in relation to sport in policy, research and practice. That sport has some kind of significance for and connection to public health is clear. But how can we understand the relationships between sport and public health?

The aim of this presentation is to argue that what is regarded as knowledge about the relationship between sport and public health largely depends on how the concepts of public health, health, health promotion and sport are framed.

Methods

In this presentation, we theorize the relationship between sport and public health as different patterns and give examples of how sports clubs can thus act as a health-promoting setting for different target groups.

Results

A first attempt to categorize the patterns in the four categories (i) health promotion as an outcome of sport, (ii) health promotion through sport, (iii) health promotion in sport, and (iv) health promoting sport. In these four categories we reveal research, that because of how they define health promotion and sport, are quite different. The different categories also use the concept of sport differently, as something that will always be healthy because it contains physical activity, as a mean, as an arena where you reach people or in a more integrated way.

Conclusions

We argue that it is not enough to recognize that physical activity and sport are good for people's physical health. By using a more inclusive conceptualization of how health can be promoted in, through and as health-promoting sport, health promotion studies can feed into the conclusions of other studies, i.e. what can be done about the how-question. What we propose and provide empirical examples of in this presentation can be seen as a theoretical basis for discussing the relationship or relationships between sport and public health that can be used in policy, research and practice. It is therefore possible to broaden the issue, to make it more complex, to go beyond compartmentalized thinking and to contribute to sustainable change in sport. Because, sustainable sport can be a question of how!

Support/Funding Source

None
S16-1 Get Finland Moving programme
Authors: Aalto-Nevalainen Päivi
Published: September 2024

Purpose

With the introduction of the new governmental programme, the Finnish Government targets to increase physical activity across all age groups. To accomplish this goal, a comprehensive cross-administrative initiative called the 'Get Finland Moving' programme has been initiated, aiming to promote physically active lifestyles. The program is grounded in phenomenon-based thinking and leveraging a thorough evaluation of the branches within each of the 12 Ministries. This evaluation assessed each Ministrýs relationships, roles, and opportunities to promote physical activity within society.

Project or policy description

Over the past years, Finland has developed a comprehensive, well-managed package dedicated to promoting physical activity across all age groups. The 'Get Finland Moving' programme is poised to further fortify and expand the cross-administrative initiatives aimed at increasing physical activity. The government executes the action plan through various measures, such as reinforcing physically active practices in early childhood education, schools, and educational institutes. Additionally, integrating physical activity into the development of work ability and workplaces is a key focus. Steps will be taken to enhance physical activity promotion skills and competence in different educational sectors, including healthcare, social welfare, and education sciences. Efforts will also be directed towards improving lifestyle counselling and physical activity guidance in municipalities and well-being service counties.

Furthermore, initiatives include adding a ball to the maternity pack and increasing the provision of advice on physical activity for families at maternity and child health clinics. The promotion of physically active lifestyles will be incorporated into the Act on Primary and Lower Secondary Education, as well as in the reform of land use legislation. Additionally, measures involve exploring and evaluating options for promoting physical activity through taxation and examining the feasibility of guaranteeing a subjective right to outdoor recreation for older people.

Conclusion

One distinctive aspect of the programme is its management and monitoring at the government level, with measures intricately aligned with the diverse administrative branches of various ministries. Another noteworthy feature involves a meticulous analysis of how different administrative branches are connected to the promotion of physical activity.
S16-4 SLOfit Lifelong: citizen science approach to promote and maintain physical fitness and physical literacy across the lifespan
Authors: O'Hehir Colin , Brosnan Paul
Published: September 2024

Purpose

SLOfit Lifelong is a public health initiative which was created to upgrade a well-established, national physical fitness surveillance system for Slovenian schoolchildren that has been collecting annual fitness data for over three decades.

Project or policy description

The ultimate objective of creating SLOfit Lifelong was to build a modern societal infrastructure with the capacity and ability to detect future causal associations between childhood physical fitness trends and future health outcomes based on the lifelong surveillance of one's own fitness status. By instilling citizens with an ambition to test, understand, and follow-up their own physical fitness and health status (including related health risk factors), this initiative provides the technical support and expert feedback needed to engender greater individual control over understanding (and thus modulating), one's own physical fitness status as they progress into older adulthood.

Conclusions

Through its sophisticated online web application My SLOfit, social media, print media, and outreach workshops, SLOfit Lifelong provides the expert support for public health engagement by fostering positive lifelong physical literacy experiences an individual can enjoy across their aging journey.
251 Development of the Physical Activity Messaging Guide to Enhance Messaging Practice across HEPA Nations
Authors: Williamson Chloë
Published: September 2024

Purpose

Physical activity (PA) messaging can help change individual and social factors, and thus contribute to improving PA levels, but improving PA messaging practice is warranted. In 2021, the Physical Activity Messaging Framework was published following a robust modified Delphi study. One purpose of this framework is to aid creation of new PA messages. However, a need to enhance dissemination and uptake of this framework in day-to-day practice was identified. Therefore, this project aimed to translate the principles of the framework to develop a practitioner-friendly messaging guide.

Methods

The framework was adapted and combined with existing evidence to create a step-by-step guide; the Physical Activity Messaging Guide (PAMG). Following this, formal feedback on PAMG was sought through online and in person meetings with members of HEPA/WHO Europe. This feedback was acted on to develop a further draft, which was shared more widely via an online, open-questioned survey (Qualtrics) to gather broader feedback.

Results

At time of writing, feedback has been gathered from 39 individuals via online survey. Responses were gathered from the UK (including Scotland, Northern Ireland, and England), the United States, Ireland, Germany, Romania, Spain, Portugal, Canada, Australia, and Finland, and came from a mixture of academics, exercise professionals, healthcare professionals, practitioners, and other (e.g., education) professions. Feedback was overall positive, with constructive recommendations for further refinement. Amendments are underway based on feedback to develop a final version of the PAMG, which will be presented at the HEPA 2024 Conference in Dublin, Ireland. Key next steps include translation of the guide into different languages to further enhance uptake.

Conclusions

Involvement in the Early Career Professional Development Programme has enabled a collaborative approach to develop and refine the PAMG. The PAMG will, as a result, be a more useful tool to various users across countries and contexts. If the PAMG is applied consistently in messaging practice, developed PA messages will be more evidence-based and target-audience focused, ultimately contributing to improving population levels of PA.

Funding Source

N/A. This work was completed as part of CW’s appointment to the HEPA/WHO Europe Early Career Professional Development Programme 2024.
Phosphorylation of RelA/p65 Ser536 inhibits the progression and metastasis of hepatocellular carcinoma by mediating cytoplasmic retention of NF-κB p65
Authors: Zuo Wentao , Ma Haoyang , Bi Jianghui , Li Tiaolan , Mo Yifeng , Yu Shiyu , Wang Jia , Li Beiqing , Huang Jinfeng , Li Yongwen , Li Li
Published: September 2024

Background

Intrahepatic and extrahepatic metastases contribute to the high recurrence rate and mortality of hepatocellular carcinoma (HCC). Constitutive activation of nuclear factor-κB (NF-κB) is a crucial feature of HCC. NF-κB p65 (p50–p65) is the most common dimeric form. Ser536 acts as an essential phosphorylation site of RelA/p65. However, the effect of RelA/p65 Ser536 phosphorylation on progression and metastases during intermediate and advanced HCC has not been reported.

Methods

Phosphorylation of RelA/p65 (p-p65 Ser536) and NF-κB p65 were detected by using immunohistochemical staining in HCC tissue samples. The biological effects of RelA/p65 Ser536 phosphorylation were evaluated by using xenograft and metastasis models. NF-κB p65 nuclear translocation was detected by using Western blotting. The binding of NF-κB p65 to the BCL2, SNAIL, and MMP9 promoters was detected by using chromatin immunoprecipitation. The biological effects on proliferation, migration, invasion, and epithelial–mesenchymal transition were assessed by using tetrazolium-based colorimetry, colony formation, EdU incorporation, flow cytometry, cell wound healing, and transwell assay.

Results

NF-κB p65 is highly expressed, while p-p65 Ser536 is not well expressed in intermediate and advanced HCC tissues. In vivo experiments demonstrated that a phosphorylation-mimetic mutant of RelA/p65 Ser536 (p65/S536D) prevents tumor progression and metastasis. In vitro experiments showed that p65/S536D inhibits proliferation, migration, and invasion. Mechanistically, RelA/p65 Ser536 phosphorylation inhibits NF-κB p65 nuclear translocation and reduces NF-κB p65 binding to the BCL2, SNAIL, and MMP9 promoters.

Conclusions

RelA/p65 Ser536 phosphorylation was detrimental to NF-κB p65 entry into the nucleus and inhibited HCC progression and metastasis by reducing BCL2, SNAIL, and MMP9. The phosphorylation site of RelA/p65 Ser536 has excellent potential to be a promising target for NF-κB-targeted therapy in HCC.
Biofilms inactivate the free-living stage of Batrachochytrium dendrobatidis, the most destructive pathogen for vertebrate diversity
Authors: Sentenac Hugo , Schmeller Dirk S , Caubet Solène , Carsin Adélaïde , Guillet Rémi , Ferriol Jessica , Leflaive Joséphine , Loyau Adeline
Published: September 2024

Emerging infectious diseases threaten biodiversity and human health. Many emerging pathogens have aquatic life stages and all immersed substrates have biofilms on their surface, i.e. communities of microorganisms producing a gelatinous matrix. However, the outcome of the interactions between environmental biofilms and pathogens is poorly understood. Here, we demonstrate that biofilms reduce the survival of the most impactful pathogen for vertebrate diversity, the invasive chytrid fungus Batrachochytrium dendrobatidis. Effects on its zoospores varied with biofilm composition in controlled settings and biofilm compositional variation also coincided with divergent impacts of chytridiomycosis on amphibian populations in nature. Our results suggest that biofilms form a biotic component of ecosystem resistance to Batrachochytrium dendrobatidis by reducing environmental transmission, and that they could be used to develop nature-based technologies to limit the impacts and spread of this invasive chytrid fungus. Our study warrants further research into the interactions between environmental biofilms and pathogenic and/or invasive micro-organisms.
Potential for international spread of Oropouche virus via commercial air travel
Authors: Portillo Mariana Torres , Marwah Anindita , Kraemer Moritz U G , Thomas-Bachli Andrea , Khan Kamran , Bogoch Isaac I
Published: September 2024

There is currently a large Oropouche virus (OROV) outbreak in Latin America and the Caribbean with several travel-related cases appearing outside of the region. We evaluate the potential for international spread of OROV via commercial air travel.
Methodology of the joint malaria prevention recommendations of Switzerland, Germany, Belgium and The Netherlands
Authors: Veit Olivia , Maniewski-Kelner Ula , Rothe Camilla , Eperon Gilles , Boering Margarita , Alcedo Sami , Boecken Gerhard , Ramharter Michael , Schel Noud , Soentjens Patrick , Staehelin Cornelia , van Vugt Michele , Weitzel Thomas , Visser Leo G , Schlagenhauf Patricia , Hatz Christoph , Neumayr Andreas ,   for the malaria working groups (listed at the end)
Published: September 2024

The expert committees for travel medicine of Belgium, Germany, The Netherlands and Switzerland endorse joint malaria prevention recommendations for travellers. Here, the methodological approach underlying these recommendations, including evidence sources used, risk category definitions and the role of expert opinion, is outlined.
The Impoverishment of Psychiatric Knowledge
Authors: Aftab Awais , Fava Giovanni Andrea
Published: September 2024

Giovanni Andrea Fava, MD, served as Associate Professor of Psychosomatic Medicine and then Professor of Clinical Psychology at the University of Bologna in Italy until the end of 2018. He is currently Clinical Professor of Psychiatry at the State University of New York (SUNY) at Buffalo, NY. He is the author of Discontinuing Antidepressant Medications (Oxford University Press, 2021). Fava’s scientific contributions to psychiatry are manifold, but his work on iatrogenic comorbidity and oppositional tolerance in psychopharmacology has received particular attention in the critical psychiatry community. For 30 years (1992–2022) he was Editor-in-Chief of the journal Psychotherapy and Psychosomatics. This interview discusses the neglect of clinical practice as a source of fundamental research questions, iatrogenic comorbidity, oppositional tolerance with use of antidepressants, and the brewing intellectual crisis in medicine and psychiatry.
Dementia Due to Other Medical Conditions
Authors: Sofko Channing A. , Naman Katya
Published: September 2024

This chapter provides an overview of cognitive impairment in older adult populations due to medical conditions that have not been addressed in previous chapters. It emphasizes the importance of thoroughly assessing all potential medical conditions that may contribute to cognitive decline via conducting thorough medical record reviews and clinical interviews. Specifically, it is essential to consider reversible causes of cognitive impairment and to determine if medical conditions may be contributing to, or explaining, cognitive and psychiatric symptoms. Equally important is evaluating the progression of cognitive changes over time and obtaining collateral reports when permitted. This chapter focuses on traumatic brain injury (TBI), multiple sclerosis (MS), and cognitive impairment secondary to endocrine dysfunction. This chapter concludes with comments on improvements in the management of human immunodeficiency virus (HIV) and the associated impact on cognition.
Risk Management
Authors: Bonner-Jackson Aaron
Published: September 2024

Dementia is a worldwide public health concern and is expected to become more common as life expectancy increases. Although some risk factors for dementia cannot be changed, a significant percentage of dementia cases worldwide can be attributed to factors that may be modified. Such factors include aspects of diet, physical activity, sleep, cognitive and social stimulation, and emotional functioning. Some factors reflect lifelong habits or behaviors, and proactive management of such factors, beginning in mid-life or earlier, is deemed to be crucial to reducing risk for development of dementia in older age. Additionally, interventions that address several factors simultaneously appear most successful in reducing dementia risk.
Chaperones and Personal Privacy
Authors: Bulger Jeffrey W.
Published: September 2024

Abstract: Using chaperones in healthcare examinations to aid comfort and respect for the patient’s dignity should not be underestimated. Patients should be given the choice to have a family member or non-family member chaperone present, and all institutional and legal requirements for chaperone use should be disclosed. Privacy should be provided for undressing, and the examination should not violate the patient’s dignity. Confidential patient information should not be discussed in the presence of the chaperone or family members unless there is explicit patient permission to do so to avoid Health Insurance Portability and Accountability Act (HIPAA) confidentiality violations. Communication between the patient and practitioner must allow for a private conversation to discuss confidential information freely. Chaperones and privacy are crucial for healthcare, and HIPAA confidentiality requirements must be respected.
Errors
Authors: Bulger Jeffrey W.
Published: September 2024

Abstract: The patient–practitioner relationship is built on trust and confidentiality of protected health information. The patient has the right to be informed about all healthcare errors that may affect their healthcare and make an informed consent decision; violating this right violates the patient’s autonomy legal, professional, and moral rights. The practitioner’s professional principles of beneficence (do good) and nonmaleficence (do no harm) require that errors be disclosed in a timely manner to maximize the patient’s best interests. As a matter of justice, the patient has the right to know about healthcare errors, and the practitioner has a duty to report errors to the institution so an institutional root cause analysis can occur. Failure to disclose healthcare errors and report them to the institution is a legal, professional, moral, and institutional policy violation. The practitioner has a professional and moral obligation to disclose healthcare errors.
Gifts
Authors: Bulger Jeffrey W.
Published: September 2024

Abstract: The gift-giving tradition is common in human societies and is used to develop social bonds and express gratitude. Practitioners should accept low-value token gifts and cards from patients. However, gifts that compromise a patient’s autonomy, the practitioner’s professional principles, or the relationship between the patient and the practitioner must not be accepted. Industry gifts meant to buy influence should also be declined. Exceptions can be made for gifts that benefit patients or fund healthcare education as long as the industry has no influence on the educational content. Practitioners must decline gifts that violate social justice and decrease society’s trust in the healthcare profession.
Impaired Practitioner
Authors: Bulger Jeffrey W.
Published: September 2024

Abstract: Recognizing and reporting impaired practitioners to protect patients and maintain public trust in the healthcare profession is a professional obligation. Practitioners have a mandatory duty to report an impaired colleague, and it is considered best practice to seek counsel from other colleagues and institutional officials before reporting. Reporting practitioners are protected from liability if they are acting in good faith, honestly, and without malice. Practitioners are also obligated to help an impaired colleague get the necessary healthcare and rehabilitation. The health and wellness of practitioners are essential for fulfilling professional obligations of maximizing patients’ best interests. The mandatory duty to report an impaired practitioner reduces individual liberty but promotes patient autonomy. The duty to report is a professional obligation and a matter of public justice to maintain social trust in the healthcare profession.
Reportable Infections and Illnesses
Authors: Bulger Jeffrey W.
Published: September 2024

The reporting of reportable infections and illnesses in the United States is divided into four categories: written, telephone, number of cases, and cancer registry. Practitioners have a patient-centered obligation to maximize the patient’s best interests while adhering to the principles of beneficence (do good) and nonmaleficence (do no harm). The practitioner must disclose their legal and professional obligation to report to the patient, but if informed consent is not obtained, the practitioner must report the minimum information required to the proper authorities. Public policies protect individual rights and liberties and promote equitable opportunities for all citizens. Failure to report a communicable infection is a misdemeanor punishable with a fine and up to 90 days imprisonment. The practitioner must balance their duty to promote patient autonomy and confidentiality with their legal obligation to report and warn those at risk of harm.
Suicide risk in Latin America: International migrants, prison populations, and sexual minorities
Authors: Mundt Adrian P. , Fritz Francesco D. , Cabieses Báltica
Published: September 2024

This chapter informs about suicide risk, suicidal behaviour, and suicide prevention in social minority groups in Latin America. The populations addressed in this chapter are heterogeneous: international migrants, prison populations, and sexual minorities. They have in common that their conditions are stigmatized in many cultures, which can lead to rejection, discrimination, and marginalization in society. Those social stressors can increase the prevalence of mental health problems. As a consequence of marginalization and administrative barriers, access to health systems may be reduced. The number of international migrants in Latin America has increased in the context of political crises and natural disasters. Prison populations have more than doubled in Latin America in the past two decades, and suicide risk is highly prevalent. Legal rights of sexual and gender minorities have recently improved in Latin America, while the experience of discrimination and violence is still common.
Mass media and suicide in low- and middle-income countries: Learnings from India
Authors: Armstrong Gregory , Vijayakumar Lakshmi
Published: September 2024

Responsible media reporting of suicides is one of the key pillars of suicide prevention, for which the World Health Organization has prescribed media guidelines. However, most of the evidence supporting this intervention is based on research from a small number of high-income countries. This chapter discusses findings from research into media and suicide in India, including the impact of culture and colonial legacies on media reporting, and the need to understand the broader ecosystem within which media reporting takes place. The chapter highlights the need for nuance and care to be taken to ensure successful local implementation of media guidelines.
Introduction
Authors: Prineas Stavros , Smith Andrew F. , Tan Suyin G.M.
Published: September 2024

Good communication is integral to managing the scale and complexity of modern clinical practice. It is a sociotechnical endeavour—a way to convey technical information, meaning, and intent, but also a way to share and connect with others; a means to an end, but also an end in itself. Anaesthesia has come a very long way since the 1840s. The advent of more selective drugs, coupled with ever more sophisticated technology, has made the practice of anaesthesia safer, yet also more complicated. This chapter introduces the reader to the idea of communication, the various ways it can be conceptualized, its impact on anaesthetists in their various roles, and how it can be structured for the purposes of skills training.
Narrative and metaphor in anaesthesia
Authors: Shafer Audrey
Published: September 2024

The practice of anaesthesia is narrative based: the arc of an anaesthetic has a beginning, middle, and end, with important prefatory and epilogue sections. Communication between patient and anaesthetist or between colleagues is also frequently story-based, requiring a knowledge of context, lexicon, setting, individuals, etc. Tropes such as metaphor are a natural part of language. Even once a patient is anaesthetized, our language is replete with metaphor, such as the translation of a patient’s vital signs into visual and auditory forms of the up-down metaphor. Exploring metaphor helps us understand objectification of the patient into, for example, a container, yet also benefits our understanding of concepts such as how anaesthesia works. Because language informs how we think and also impacts others, it is critical to reflect on the surface and embedded meanings of what we say.
Consent
Authors: Simmons Scott W. , Cyna Allan M.
Published: September 2024

Striving to disentangle the entwined elements of consent, including law, ethics and autonomy, ‘GREAT’ and ‘LAURS’ are discussed in this chapter to underline the pre-eminence of effective communication as central to all. It is emphasized that in day-to-day clinical practice, there can be a shift in the informed consent discussion from a one-sided problem-based interaction, the purpose of which is to defend the doctor and organization against litigation, to one where the patient–doctor communication is mutually solution-focused and has therapeutic value. This emphasizes that consent can be achieved and then maintained beyond a single pre-procedure meeting by creating a sense of common purpose and a therapeutic alliance that encompasses both outcome and process. It is further highlighted how utilizing this perspective can guide how much, and in what form, information could be provided in relation to clinical risk and avoid unnecessary harm secondary to the nocebo effect.
Variation in Mpox Vaccine Coverage in the United States: Influence of Political Orientation and Public Health Resources
Authors: Kang HeeEun , Rovelsky Suzette , Kang Nam Hoon , Talbot Elizabeth A , Murphy Richard A
Published: September 2024

During the 2022–2023 mpox outbreak in the United States, the federal government distributed mpox vaccines to individual states. Significant variation in vaccine coverage was noted across states. State-level factors associated with higher vaccine coverage were Democratic political orientation, higher public health spending, higher proportion of at-risk population, and higher mpox cases.
Is Iteration an Object of Intuition?
Authors: Bentzen Bruno
Published: September 2024

In ‘Intuition, iteration, induction’, Mark van Atten argues that iteration is an object of intuition for Brouwer and explains the intuitive character of the act of iteration drawing from Husserl’s phenomenology. I find the arguments for this reading of Brouwer unconvincing. In this note I set out some issues with his claim that iteration is an object of intuition and his Husserlian explication of iteration. In particular, I argue that van Atten does not accomplish his goals due to tensions with Brouwer’s comments on second-order mathematics and because Husserl does not understand the experience of succession as Brouwer does.
Anhedonia Across and Beyond the Schizophrenia Spectrum
Authors: Chan Raymond C K , Wang Ling-ling , Huang Jia , Wang Yi , Lui Simon S Y
Published: September 2024

Anhedonia refers to the diminished ability to experience pleasure, and is a core feature of schizophrenia (SCZ). The neurocognitive and neural correlates of anhedonia remain elusive. Based on several influential theoretical models for negative symptoms, this selective review proposed four important neurocognitive domains, which may unveil the neurobiological mechanisms of anhedonia. The authors critically reviewed the current evidence regarding value representation of reward, prospection, emotion-behavior decoupling, and belief updating in the Chinese setting, covering both behavioral and neuroimaging research. We observed a limited application of the transdiagnostic approach in previous studies on the four domains, and the lack of adequate measures to tap into the expressivity deficit in SCZ. Despite many behavioral paradigms for these four domains utilized both social and non-social stimuli, previous studies seldom focused on the social-versus-non-social differentiation. We further advocated several important directions for future research.
Homocysteine metabolites impair the PHF8/H4K20me1/mTOR/autophagy pathway by upregulating the expression of histone demethylase PHF8‐targeting microRNAs in human vascular endothelial cells and mice
Authors: Witucki Łukasz , Jakubowski Hieronim
Published: September 2024

The inability to efficiently metabolize homocysteine (Hcy) due to nutritional and genetic deficiencies, leads to hyperhomocysteinemia (HHcy) and endothelial dysfunction, a hallmark of atherosclerosis which underpins cardiovascular disease (CVD). PHF8 is a histone demethylase that demethylates H4K20me1, which affects the mammalian target of rapamycin (mTOR) signaling and autophagy, processes that play important roles in CVD. PHF8 is regulated by microRNA (miR) such as miR‐22‐3p and miR‐1229‐3p. Biochemically, HHcy is characterized by elevated levels of Hcy, Hcy‐thiolactone and N‐Hcy‐protein. Here, we examined the effects of these metabolites on miR‐22‐3p, miR‐1229‐3p, and their target PHF8, as well as on the downstream consequences of these effects on H4K20me1, mTOR‐, and autophagy‐related proteins and mRNAs expression in human umbilical vein endothelial cells (HUVEC). We found that treatments with N‐Hcy‐protein, Hcy‐thiolactone, or Hcy upregulated miR‐22‐3p and miR‐1229‐3p, attenuated PHF8 expression, upregulated H4K20me1, mTOR, and phospho‐mTOR. Autophagy‐related proteins (BECN1, ATG5, ATG7, lipidated LC3‐II, and LC3‐II/LC3‐I ratio) were significantly downregulated by at least one of these metabolites. We also found similar changes in the expression of miR‐22‐3p, Phf8, mTOR‐ and autophagy‐related proteins/mRNAs in vivo in hearts of Cbs−/− mice, which show severe HHcy and endothelial dysfunction. Treatments with inhibitors of miR‐22‐3p or miR‐1229‐3p abrogated the effects of Hcy‐thiolactone, N‐Hcy‐protein, and Hcy on miR expression and on PHF8, H4K20me1, mTOR‐, and autophagy‐related proteins/mRNAs in HUVEC. Taken together, these findings show that Hcy metabolites upregulate miR‐22‐3p and miR‐1229‐3p expression, which then dysregulate the PHF8/H4K20me1/mTOR/autophagy pathway, important for vascular homeostasis.
The Epstein–Barr virus small capsid protein BFRF3 disrupts the NF‐кB signaling pathway by inhibiting p65 activity
Authors: Li Meili , Li Yiwen , Liu Yintao , Li Xiaoqing , Lao Shuxian , Long Zhiwei , Huang Chen , Huang Wenzhuo , Xu Chunyan , Chen Xinru , Adam Fathalrhman Eisa Addoma , Zhang Guirong , Li Linhai , Zhang Jian , Peng Tao , Su Meiting , Chen Shengwen , Hou Shaozhen , Xiao Bin , Cai Mingsheng
Published: September 2024

Epstein–Barr virus (EBV), a common gamma herpesvirus, establishes a life‐long latent infection in the host to defend against innate immune recognition, which is closely related to a variety of malignant tumors, but its specific mechanism is unclear. BFRF3, an EBV‐encoded small capsid protein, is mainly involved in the assembly of the viral capsid structure and the maintenance of its stability. Here, we showed that BFRF3 can inhibit TNF‐α‐mediated NF‐кB promoter activation. Moreover, BFRF3 downregulates NF‐кB‐mediated promoter activation and transcription of inflammatory cytokines, including IL‐6 and IL‐8. Dual‐luciferase reporter assay demonstrated that BFRF3 restrains NF‐кB promoter activity at or below the p65 level, and coimmunoprecipitation analysis revealed that BFRF3 not only interacts with p65 but also binds to its critical truncated Rel homology domain (RHD) and transcriptional activation domain (TAD). However, BFRF3 does not affect the dimerization of p65‐p50, but overexpression of BFRF3 reduces the nuclear accumulation of p65, and the phosphorylation of p65 (Ser536) is repressed during BFRF3 transfection and EBV lytic infection, which promotes the proliferation of EBV. Overall, our study suggested that BFRF3 may play a crucial role in antiviral immunity to defend against EBV infection by inhibiting NF‐κB activity.
Physical Therapist Faculty Perceptions of Barriers Related to High Fidelity Simulation Manikins
Authors: Thomas René , Wiley Steve , Borrero Lisa , Greenwood Kristin
Published: September 2024

Background and Purpose:

The purpose of this basic interpretive qualitative study was to explore physical therapist faculty members’ perceptions of barriers related to teaching with high fidelity simulation (HFS) manikins within the Doctor of Physical Therapy (DPT) curriculum.

Case Description:

Eight physical therapist faculty members with no experience teaching with HFS manikins participated in semi-structured one-on-one interviews to understand their perceptions of barriers to this type of HFS as a teaching methodology within the DPT curriculum.

Outcomes:

Three overarching themes arose through qualitative analysis, which describe participants’ perceptions. Major themes were: (1) HFS manikins are unnecessary to achieve course objectives; (2) HFS manikins are not human; and (3) Teaching with HFS manikins may not be worth the effort.

Discussion and Conclusion:

The findings of this study can assist DPT programs, faculty, and Program Directors consider including HFS manikins into the curriculum by increasing awareness of potential barriers among those individuals who have not taught with HFS manikins. Further research is warranted to continue to explore the evolving role this technology has in the DPT curriculum.
A Pilot Non-Inferiority Study of Effectiveness of Face-to-Face Versus Virtual Reality on Undergraduate Physiotherapy Students’ Confidence and Self-Efficacy With Tracheostomy Skills
Authors: Twose Paul , Hawker Clare , Bendall Amy
Published: September 2024

Introduction:

The number of tracheostomies performed annually in resource-rich countries is estimated at 250 000. Without adequate training, staff caring for patients with tracheostomies can feel underprepared, lacking both competence and confidence. Training is essential to support both patients and health care staff but is often sporadic and nonstandardized and rarely includes those at preregistration level. The purpose of this study was to explore the potential for delivering a newly developed virtual reality (VR)-based tracheostomy education with traditional face-to-face teaching to undergraduate physiotherapy students.

Methods:

A pilot non-inferiority study with randomization of interventions comparing traditional face-to-face teaching with a VR-based tracheostomy education program. The content of both training approaches was standardized and based on local existing education content. The primary outcome was changes in knowledge, confidence, and self-efficacy.

Results:

Thirty-nine undergraduate physiotherapy students were recruited, with 18 (47.4%) receiving tracheostomy training via VR. All participants demonstrated significant improvements in knowledge, confidence, and self-efficacy when comparing pre- and posttraining. A greater change was observed in those receiving VR-based training although not statistically significant. Additional results showed a reduction in facilitator activity during the VR sessions but a requirement for technical support.

Conclusions:

VR-based tracheostomy training is equivocal to face-to-face training for increasing undergraduate students’ knowledge, self-efficacy, and confidence. There may be additional benefits of VR-based training including reduced facilitator training time, but these need to be further assessed considering the technical support required for immersive technology.