Spotlight on Japanese physicians: An exploration of their professional experiences elicited by means of narrative facilitators.

While investigation of physicians' work experience is often limited to issues of satisfaction or burnout, a broader view of their experiences is lacking. To explore professional experiences, we asked Japanese physicians (N = 18, 12 men and 6 women) of a general hospital to react to so-called "narrative facilitators". The narrative facilitators - inspired by clinical psychology, visual sociology and purpose-designed techniques - oriented physicians' narratives towards clinical practise, relationship with peers and context. Transcribed interviews were subject to thematic analysis. The thematic analysis of participants' narratives revealed a lonely physician with a tough job, torn between the ideal of patient-centred care and a clinical reality, which limits these aspirations. Patients emerged as anxious and burdensome consumers of medicine. Feeling neither supported by peers nor the institution, physicians also perceived the society as somewhat negligent, delegating its problem to medicine. Communication difficulties, with patients and peers, and the absence of joyful aspects of the profession constituted fundamental elements of their narratives. Comprehensive investigation of physicians' lived professional experience could become a key to conceive ways to support them

Assessing Physical Activity in People With Mental Illness: 23-country Reliability and Validity of the Simple Physical Activity Questionnaire (SIMPAQ)

Background: Physical inactivity is a key contributor to the global burden of disease and disproportionately impacts the wellbeing of people experiencing mental illness. Increases in physical activity are associated with improvements in symptoms of mental illness and reduction in cardiometabolic risk. Reliable and valid clinical tools that assess physical activity would improve evaluation of intervention studies that aim to increase physical activity and reduce sedentary behaviour in people living with mental illness. Methods: The five-item Simple Physical Activity Questionnaire (SIMPAQ) was developed by a multidisciplinary, international working group as a clinical tool to assess physical activity and sedentary behaviour in people living with mental illness. Patients with a DSM or ICD mental illness diagnoses were recruited and completed the SIMPAQ on two occasions, one week apart. Participants wore an Actigraph accelerometer and completed brief cognitive and clinical assessments. Results: Evidence of SIMPAQ validity was assessed against accelerometer-derived measures of physical activity. Data were obtained from 1010 participants. The SIMPAQ had good test-retest reliability. Correlations for moderate-vigorous physical activity was comparable to studies conducted in general population samples. Evidence of validity for the sedentary behaviour item was poor. An alternative method to calculate sedentary behaviour had stronger evidence of validity. This alternative method is recommended for use in future studies employing the SIMPAQ. Conclusions: The SIMPAQ is a brief measure of physical activity and sedentary behaviour that can be reliably and validly administered by health professionals.Universidad Pablo de Olavide de Sevilla. Departamento de Deporte e Informátic

Effects of nonylphenol on hematological parameters and immune responses in immature rainbow trout (Oncorhynchus mykiss)

This study investigated the effects of nonylphenol (NP) on hematological and immunological parameters in both male and female rainbow trout (Oncorhynchus mykiss). Fish were randomly distributed into six groups and administered with NP (10, 50 and 100 μg g-1 week-1 BW) and a single dose of 17-β estradiol (E2; 2 μg g-1 week-1 BW, positive control). The solvent controls received ethanol and coconut oil as a vehicle, while the controls were not injected. Red blood cells (RBCs) count, hematocrit (Hct), hemoglobin (Hb), white blood cells (WBCs), and lymphocytes demonstrated a NP dose-dependent decrease, whereas mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), monocytes, and neutrophils showed an increasing trend in both male and female fish 21 days post-treatment. Also, RBCs, Hb, MCHC, WBCs, and lymphocytes were significantly reduced (p<0.05) in E2 treated fish. Lysozyme, complement components (C3 and C4) and immunoglobulin M (IgM) were increased in fish sera subjected to 10 and 50 μg g-1 NP, while these decreased in groups administered with 100 μg g-1 NP and 2 μg g-1 E2. Except for C4 level at 10 μg g-1 NP, no significant differences were observed in hematological and immunological parameters of male and female in each treatment. Overall, a frequent exposure to NP could lead to adverse effects on fish immune-physiological functions which may cause serious ecological threats of fish natural population sustainability

Lifetime prevalence, sociodemographic predictors, and comorbidities of oppositional defiant disorder: The national epidemiology of iranian child and adolescent psychiatric disorders (IRCAP)

Objective: This was the first national epidemiological study on oppositional defiant disorder (ODD) in Iran, which provided new information about the prevalence, comorbidities, and sociodemographic predictors of ODD. Methods: Data from a face-to-face household survey of 30,532 children and adolescents aged 6-18 years were collected from across all 31 provinces of Iran using a multistage cluster sampling design. The Persian version of the Kiddie Schedule for Affective Disorders and Schizophrenia for School-Age Children � Present and Lifetime Version (K-SADS-PL) was used in this study. Results: The lifetime prevalence of ODD was found to be 3.9. ODD was significantly more common in boys than girls and appeared in late adolescence more frequently than in childhood. A lower prevalence of ODD was found among participants who lived in rural areas. ODD is highly likely to co-occur with attention deficit hyperactivity disorder, separation anxiety disorder, generalized anxiety disorder, and depressive disorders. Conclusions: The findings of this national population-based study confirm and extend previous findings on the prevalence, comorbidities, and sociodemographic predictors of ODD. © 2020, Associacao Brasileira de Psiquiatria. All rights reserved

Prevalence and correlates of psychiatric disorders in a national survey of Iranian children and adolescents

Objective: Considering the impact of rapid sociocultural, political, and economical changes on societies and families, population-based surveys of mental disorders in different communities are needed to describe the magnitude of mental health problems and their disabling effects at the individual, familial, and societal levels. Method: A population-based cross sectional survey (IRCAP project) of 30 532 children and adolescents between 6 and 18 years was conducted in all provinces of Iran using a multistage cluster sampling method. Data were collected by 250 clinical psychologists trained to use the validated Persian version of the semi-structured diagnostic interview Kiddie-Schedule for Affective Disorders and Schizophrenia-PL (K-SADS-PL). Results: In this national epidemiological survey, 6209 out of 30 532 (22.31) were diagnosed with at least one psychiatric disorder. The anxiety disorders (14.13) and behavioral disorders (8.3) had the highest prevalence, while eating disorders (0.13) and psychotic symptoms (0.26) had the lowest. The prevalence of psychiatric disorders was significantly lower in girls (OR = 0.85; 95 CI: 0.80-0.90), in those living in the rural area (OR = 0.80; 95 CI: 0.73-0.87), in those aged 15-18 years (OR = 0.92; 95 CI: 0.86-0.99), as well as that was significantly higher in those who had a parent suffering from mental disorders (OR = 1.96; 95 CI: 1.63-2.36 for mother and OR = 1.33; 95 CI: 1.07-1.66 for father) or physical illness (OR = 1.26; 95 CI: 1.17-1.35 for mother and OR = 1.19; 95 CI: 1.10-1.28 for father). Conclusion: About one fifth of Iranian children and adolescents suffer from at least one psychiatric disorder. Therefore, we should give a greater priority to promoting mental health and public health, provide more accessible services and trainings, and reduce barriers to accessing existing services. © 2019 Tehran University of Medical Sciences. All rights reserved