Physical activity and its relationship with national-based examination results among adolescents

Introduction This study investigated the longitudinal relationship between self-reported physical activity and national examination results among adolescents in an upper-middle-income country. Methods This study engaged in a secondary data analysis derived from a closed prospective cohort consisting of 579 students, who were recruited at the age of 13 in 2012 and followed up at ages 15 (2014) and 17 (2016) as part of the Malaysian Health and Adolescents Longitudinal Research Team (MyHeART) study, which was conducted across three states in Peninsula Malaysia. Physical activity levels were evaluated using the Physical Activity Questionnaire, and outcomes were assessed based on the National-Based Examinations at ages 15 (Form 3, Year 9) and 17 (Form 5, Year 11) in Malaysia. A multivariate ordinal regression employing complex sample analysis was applied to ascertain the relationship between physical activity and national examination results. Results In Form 3 (Year 9), those physically active performed better in Malay Language, English Language, Mathematics and Science. Those physically active in Form 5 (Year 11), performed better in Modern Mathematics, Chemistry, and Principles of Accounting. Longitudinally, there was an increase in the overall percentage of those who were overweight and obese and an increase in those with suboptimal dietary and iron intake. Conclusions This study has shown that those physically active students fared better in several subjects in the national-based examinations. Suitable physical activity intervention should be tailored accordingly to support adolescents’ optimum achievement in academia

Predicting placebo analgesia responses in clinical trials: where to look next? A meta-analysis of individual patient data

Estimating the magnitude of placebo responses across pharmacological and non�pharmacological trials is important for understanding their influence on trial outcomes. Yet, the extent to which more intense placebo interventions like sham acupuncture yield larger analgesic responses than placebo pills, and the factors predicting these responses, remain unclear. This meta-analysis investigated the magnitude and predictors of placebo analgesia responses in pharmacological versus acupuncture trials. Analyses included individual patient data from the placebo arm of 11 randomized controlled trials (RCTs): Nine pharmacological RCTs using placebo pills (N = 2021) and two acupuncture RCTs using sham acupuncture (N = 747). All trials were conducted in patients with chronic nociceptive pain (osteoarthritis, N = 2068; low back pain, N = 700). The placebo response was calculated as the change in pain intensity (0- 100) between baseline and week 12. A random effects model demonstrated that placebo pills and patients with osteoarthritis exhibited smaller placebo responses than sham acupuncture and patients with low back pain (both p<0.001, small effects). A mixed effects model showed that route of administration interacted significantly with baseline pain, premature termination, and the presence of adverse events. Predictors explained 20-25% of the individual variance in placebo responses, while 75-80% remained unaccounted for. In summary, sham acupuncture accounted for slightly larger placebo responses than placebo pills. While basic trial and patient parameters explained only a small portion of this variability, we might need to start considering the patient’s perception of the treatment – including cognition and emotions – to better predict placebo analgesia response

Occupational stress and wellbeing: A qualitative exploration of the perspectives and experiences of migrant sonographers practising in the United Kingdom

Objective: The objective of this study was to perform a narrative review of digital Positron emission tomography-computed tomography (PET-CT) scanners, focussing on the current development in the technology of optimized crystal size and design, the time of flight (ToF) resolution, sensitivity, and axial field of view (AFOV). Key findings: It was observed that significant developments were carried out on the optimization of scintillation crystal size which results in the improvement of spatial resolution. such developments include the upgrade in the AFOV after the integration of SiPM technology, which results in dynamic parametric imaging acquisition in PET and sensitivity boost. The improvement in ToF resolution and the better ToF resolution values, which result in a boost in adequate sensitivity and signal-to-noise ratio (SNR). Other upgrades include the use of the smallest crystal size of 2.76 � 2.76 mm, and the use of the lowest ToF resolution of 214 ps. The use of the largest AFOV of 194 cm with the highest observed NEMA sensitivity of 225 cps/kBq for the total body PET-CT system. Conclusion: Digital PET-CT systems offer various advantages such as a reduction in radiation dose from injected radiopharmaceuticals doses and the overall PET acquisition time with an improved diagnostic certainty. This is because of the better performance of the SiPM detector. Digital PET-CT also has added benefits of the dynamic acquisition and Patlak modeling capabilities into routine clinical practice with the advancement in higher AFOV PET systems. Implication: This will help the users choose the best system during the evaluation of the PET-CT for purchase in clinical and research applications. This review will further help in teaching the latest technology and developments in PET-CT systems

Qualitative exploration of consultant level therapy practice in critical care

Introduction:Non-medical consultant level roles have been in existence for over 30 years, however the number of allied health professionals (AHPs) working at this level, particularly in critical care, remains relatively small. National guidance highlights the importance of clinicians in these roles to work across the four pillars of practice. However, little research exists regarding the roles undertaken by these consultant-level practitioners, the contributions made to service delivery and their perceived impact on patient and service outcomes. Based on this, the aim of this project was to explore the perceived impact of consultant-level AHPs working within critical care. Methods:Qualitative methodology was used involving a combination of interviews and focus groups. Purposeful sampling was used to recruit AHPs in consultant-level positions within critical care. Senior medical and nursing staff were then recruited via the AHPs. Data were analysed thematically using the Braun and Clarke methodology. Results:Five consultant-level AHPs were recruited to participate in interviews, with a further 7 participants from senior medical and nursing roles participating in one of two focus groups. The AHPs had been in a consultant-level role for an average of 3.2 years, with all participants reporting over 15 years’ experience within critical care. Four core themes were generated from 105 unique codes and 13 subthemes. Personal characteristics were apparent across all themes and therefore was included as a central element. The core themes were (1) scope; (2) status; (3) supportive leadership and (4) impact. Discussion:Through four core themes, this study has highlighted the roles undertaken by consultant-level AHPs working in critical care, their perceived impact on patient and service outcomes, and their contribution to local, regional and national workstreams. Where these roles exist, they appear to be well received by senior medical and nursing staff, reporting the benefits of highly experienced members of clinical staff to improve service delivery, patient outcomes and contribute to strategic planning

Program standards and student competencies among global chiropractic accreditation agencies: a content analysis

Background Accreditation of healthcare provider training programs ensures graduate competency and provides a means for programs to improve. Accreditation consistency assures the public that healthcare providers have similar basic training across world regions. Currently, it is unknown if chiropractic accrediting agencies have congruent standards globally. Therefore, the purpose of this study was to investigate similarities and differences in student competencies and program standards among four chiropractic accreditation agencies worldwide. Methods A quantitative content analysis was performed on accreditation standards from regional international accreditation agencies responsible for accrediting the majority of the world’s chiropractic degree programs. Agencies included the Council on Chiropractic Education (United States), the European Council on Chiropractic Education (Europe, United Kingdom, South Africa), the Council on Chiropractic Education Australasia (Australia, New Zealand, Malaysia), and the Council on Chiropractic Education Canada (Canada). The contents of the accrediting standards were coded using a standardized coding list. A modified Delphi technique was used by 21 international experts from December 1, 2023, to April 18, 2024. After four rounds of consideration to achieve consensus, the contents were analyzed for frequency and congruence of coded items across the accrediting agencies’ standards. A two-way analysis of variance was conducted to identify if there were any differences among the accreditation agencies. Results Neither student competencies [F(3,8)=0.007, p>.05] nor program standards [F(3,4)=0.002, p>.05] differed significantly across the accrediting agencies. The statistical relationships between accreditation agencies and coding frequencies remained stable across all coded items, with no single code exhibiting differential performance depending on the accrediting body. The overall model showed R2=0.96 for student competencies and R2=0.87 for program standards; thus, the models’ predictions align with the observed data. Conclusions The study findings demonstrate congruence for student competencies and program standards among chiropractic accreditation agencies across multiple geographic regions. The patterns of content were stable

Advancing Equitable Osteopathic Practice: Integrating Person-Centredness & Addressing Racial Biases Through the Lens of Critical Theory

As osteopaths, many of us ideally endeavour to minimise biased interpretations when evaluating the pain and distress expressed by individuals seeking treatment. However, as a product of the society we live in, we acknowledge that various unconscious biases, including racial bias, may unintentionally and spontaneously influence our view of a patient's condition and perception of pain. This paper explores the intersection of Person-Centred Care (PCC) and racial biases through critical theory in the context of osteopathic practice. It emphasises the ethical duty of healthcare professionals to deliver PCC that recognizes individual experiences, values, needs, and abilities. Racial biases within healthcare settings are identified as contributors to disparities in access, quality, and outcomes. They can also lead to bias in the clinical decision-making process requiring attention in osteopathic clinical practice. The critical theory framework allows for the identification of opportunities and barriers to implementing PCC and equity in osteopathic practice, highlighting factors such as the impact of implicit bias and structural barriers. As a result, osteopaths are recommended to take a proactive approach through self-awareness, challenging personal beliefs and actively engaging in cultural humility to minimise racial biases. Osteopathic education could contribute to the cultivation of cultural humility and awareness in training programmes, fostering a passion for fair healthcare among future osteopathic professionals. Ultimately, the integration of critical theory and PCC through cultural humility is presented as an approach to promoting equitable healthcare that empowers individuals

European research Priorities for Osteopathic Care (PROCare): a sequential exploratory investigation and survey

Objectives The aim of this study is to identify and analyse research priorities across the osteopathic profession internationally, to determine how different interested parties conceptualise research importance and to examine how contextual factors influence research prioritisation. Design A mixed methods sequential exploratory design combining an umbrella review, a thematic analysis, an expert consensus agreement and an international cross-sectional survey was used to define, validate and evaluate research priorities. Setting An international online survey, available in nine languages, was distributed through professional osteopathic organisations and network worldwide, a patient representative organisation and social media. Participants 2229 respondents including patients (7.4%), practitioners (42.1%), students (17.4%), educators (13.5%), researchers (5.0%) and policy makers (4.3%) from across 42 countries. Primary and secondary outcome measures Primary outcomes were interested party’s conceptualisation of research importance and validation of the priorities in Research for Osteopathic Care (PROCare) framework. Secondary outcomes included current research priorities across interested parties groups and influence of contextual factors on prioritisation. Results Three distinct approaches to priority-setting emerged: conservative (42.9%), sceptic (20.2%) and enthusiast (36.9%). Organising research priorities as a construct built from domains and subdomains was shown to be internally valid (Cronbach’s α=0.911). ‘Patient safety’ (nominated by 82% of relevant countries) and ‘physical activities and mobility’ (51.0%) were the most prioritised subdomains. ‘Digital health’ ranked lowest (28th of 28 subdomains). Significant geographic variations were observed mainly for the overall importance to most research domains. Strong consensus emerged around core priorities including patient safety, physical activity promotion and understanding treatment mechanisms. Conclusions The PROCare framework provides a validated structure for evaluating osteopathic research priorities across diverse interested parties. While geographic variations exist in priority emphasis, fundamental agreement on key research domains suggests potential for internationally coordinated research strategies. Future work should focus on developing mechanisms to ensure balanced representation of conservative, sceptic and enthusiast perspectives in research planning

Navigating eating, drinking and swallowing in adults: 50 top tips from A- Z

This book offers accessible and concise information to enable both student and qualified clinicians to navigate essential eating, drinking and swallowing (EDS) knowledge and equip them to meet relevant clinical competencies. Arranged alphabetically, the book provides an A to Z of EDS assessment and management in adults, guiding readers through key aspects, from aetiologies to xerostomia and from cranial nerve assessments to videofluoroscopy. This dip in, dip out resource is packed with information of immediate clinical relevance, facilitating synthesis between theory and practice, and encourages readers to view their clients in a holistic, person-centred way. It contains printable resources and concludes with a useful appendix providing worked examples of clinical scenarios. Divided into 50 tips to enhance practice, this pocket-sized guide is an essential resource for all trainee and newly qualified speech and language therapists, as well as more experienced clinicians moving into the field

Kainate Receptors Trafficking Signalling and Functional Roles

Kainate receptors (KARs) regulate glutamate-mediated ion flow in the brain, influencing neurotransmission and synaptic plasticity. KARs are comprised of primary and secondary subunits, forming tetramers with diverse functions based on their composition. Precise trafficking and localisation, modulated by splicing, post-translational modifications and protein interactions, are crucial for synaptic modulation and plasticity. Dysregulation of KARs is implicated in many neurodevelopmental and neurological disorders such as temporal lobe epilepsy, autism spectrum disorder and major depressive disorder. Understanding the KAR function offers insights into therapeutic interventions for these conditions. This chapter explores KARs role in synaptic balance, neural network integrity and the pathogenesis of neurological disorders, highlighting their potential as therapeutic targets

Associations of Physical Activity and Sedentary Behavior with Internalizing Problems among Youth with Chronic Pain

Background: Taking actions to maintain a healthy lifestyle, including regular engagement in physical activity (PA) and reducing sedentary behavior (SB), may protect against the development of internalizing problems among healthy youth. However, it remains unclear whether such associations exist among youth with chronic pain who often report symptoms of depression and anxiety. To this end, we aimed to investigate the associations between independent and combined PA and/or SB patterns with indicators of internalizing problems in this vulnerable population. Methods: Data used in this cross-sectional study were retrieved from the U.S. National Survey of Children’s Health for the years 2021–2022. Specifically, caregiver proxy reports on sociodemgraphic factors and lifestyle behaviors of 4735 U.S. children and adolescents (referring to youth) aged 6–17 years were collected. We examined independent and combined patterns of PA and SB as exposures, with internalizing problems serving as outcomes of interest. Logistic regressions were used to examine the independent and combined associations of PA and/or SB patterns with anxiety and depression symptoms among youth with chronic pain while adjusting for covariates including age, sex, ethnicity, primary caregivers’ education level, overweight status, and household federal poverty level. Results: Overall, our results indicated that PA was negatively associated with anxiety and depressive symptoms. Specifically, youth with chronic pain who engaged in at least 60–minute PA for 1–3 days, 4–6 days, or every day reported significantly lower likelihood of experiencing symptoms of anxiety (OR = 0.71, 95% CI: 0.60–0.84; OR = 0.44, 95% CI: 0.36–0.53; OR = 0.50, 95% CI: 0.40–0.63, respectively; all p-value < 0.001) and depression (OR = 0.63, 95% CI: 0.53–0.75; OR = 0.38, 95% CI: 0.31–0.47; OR = 0.46, 95% CI: 0.36–0.59, respectively; all p-value < 0.001) symptoms compared to those with 0 days. Conversely, SB (operationalized via the proxy screen time) was positively associated with anxiety and depression symptoms. Youth with chronic pain who reported 4 or more hours of daily screen time had significantly higher odds of experiencing symptoms of anxiety (OR = 2.17, 95% CI: 1.52–3.09, p < 0.001) and depression (OR = 2.30, 95% CI: 1.48–3.59, p < 0.001). Furthermore, youth with chronic pain who engaged in higher PA levels and reported lower SB levels had a lower likelihood of experiencing symptoms of anxiety (OR = 0.68, 95% CI: 0.52–0.87, p = 0.003) and depression (OR = 0.49, 95% CI: 0.34–0.70, p < 0.001) symptoms compared to those with lower PA levels and higher SB levels. Conclusions: Higher PA levels and lower SB levels were associated with a reduced likelihood of developing anxiety and depression symptoms, which are indicative of internalizing problems, among youth with chronic pain. Future public health actions in this vulnerable population should prioritize intervention programs that promote PA engagement to reduce SB levels