The biopsychosocial model and hypothyroidism

This paper comments on the role and emergence of the biopsychosocial model in modern medical literature and health care settings. The evolution of the biopsychosocial model and its close association with modern pain theory is also examined. This paper seeks to discuss the place of this model with respect to the management of hypothyroidism. This discussion represents a forerunner to a randomised control trial that will seek to investigate the effect of a biopsychosocial-based treatment regime on hypothyroidism

Erratum to: Quality of reporting of randomised controlled trials in chiropractic using the CONSORT checklist

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Chronic recurrent ankle sprain: A randomized clinical trial studying the impact of two treatment protocols

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Predictors of intention translation in flexible sigmoidoscopy screening for colorectal cancer

Objective: This prospective study aimed to identify predictors of intention and subsequent attendance of flexible sigmoidoscopy screening using constructs derived from the Health Belief Model (HBM). Method: A total of 4,330 people aged 54 years and registered at 1 of 83 participating English general practices were sent a preinvitation questionnaire to assess sociodemographics, HBM variables including perceived benefits, barriers, seriousness, health motivation, and external cues to action as well a range of other constructs and personal characteristics known to relate to cancer screening. Results: Of the 1,578 respondents (36.4%), 1,555 (98.5%) answered the intention question: 52.9% stated definitely yes, 38.1% probably yes, 6.8% probably not, and 2.2% definitely not. Intentions were positively associated with a higher score on a scale of benefits (odds ratio [OR] = 4.62; 95% confidence intervals [CI; 3.24, 6.59]) and health motivation, that is, interest in other ways of preventing colorectal cancer (OR = 2.61; 95% CI [1.62, 4.22]), while a higher score on perceived barriers (OR = 0.19; 95% CI [0.12, 0.31]) and currently following recommended healthy lifestyle behaviors (OR = 0.31; 95% CI [0.16, 0.59]) were negatively associated. Attendance was verified for 922 intenders (65.2%) of whom 737 (79.9%) attended. Attendance was predicted by health motivation (OR = 1.75; 95% CI [1.07, 2.86]), perceived benefits (OR = 1.82; 95% CI [1.37, 2.43]), perceived barriers (OR = 0.47; 95% CI [0.32, 0.69]), individual-level deprivation (OR = 0.26; 95% CI [0.14, 0.50]), and having diabetes (OR = 0.48; 95% CI [0.25, 0.94]). Conclusion: This study supported the usefulness of the HBM in predicting cancer screening and was further enhanced by adding non-HBM variables such as individual socioeconomic deprivation and comorbidities

Evaluating the effects of PIRAC nitrogen-diffusion treatments on the mechanical performance of Ti-6Al-4V alloy

The authors would like to thank the European Regional Development Fund (Malta) for research equipment funded through the application of the project “Developing an Interdisciplinary Material Testing and Rapid Prototyping R&D Facility (Ref. no. 012)”. The authors are also greatly indebted to MATERAþ/ERA-NET Plus for funding support for this research (Project ESM-1935).Powder Immersion Reaction Assisted Coating (PIRAC) is a relatively simple nitrogen diffusion based process which has been proposed as a technique capable of considerable improvements in the tribological performance of ceramics and metals alike; however, the necessary exposure of the substrate material to high temperatures for several hours may have an adverse effect on the bulk properties of materials such as titanium alloys. The effect of PIRAC treatments on the bulk metallography and mechanical properties of Ti–6Al–4V has been studied. Following PIRAC nitrogen-diffusion treatment, studies using X-ray diffraction and cross-sectional microscopy have shown evidence of the formation of a thin (1.4 mm) TiN/Ti2N layer, together with the presence of some Ti3Al intermetallic phase. Semi- logarithmic S–N plots show a deleterious effect after PIRAC treatment in terms of material cyclic fatigue strength, particularly at higher treatment temperatures. Samples processed at 800 1C for 4 h however exhibit better fatigue performance than others treated at lower temperatures for longer nitriding times. Fractographic inspection has shown that fatigue cracks originate at (or near) the surface for the untreated Ti-alloy and from the subsurface regions following diffusion treatment, owing to the build-up of compressive stresses in the latter, which hinder crack propagation.peer-reviewe

Empowering Responsible Online Gambling by Real-time Persuasive Information Systems

Online gambling, unlike other mediums of problem- atic and addictive behaviours, such as tobacco and alcohol, offers unprecedented opportunities for building information systems that are able to monitor and understand a user’s behaviour in real-time and adapt persuasive messages and interactions that would fit their personal profile and usage context. Online gambling industry usually provides Application Programming Interfaces (APIs) meant mainly to enable third-party applications to network with their gambling services and enhance a user’s gambling experience. In this industrial practice and experience paper, we advocate that such API’s can also be used to retrieve gamblers’ online data, such as browsing and betting history, promotions and available offers and use it to build more intel- ligent and proactive responsible gambling information systems. We report on our industrial experience in this field and make the argument that data available for persuasive marketing and usability should, under specific usage conditions, also be made available for responsible gambling information systems. This principle would provide equal opportunities for both directions. We discuss the psychological foundations of our proposed solution and the risks and challenges typically found when building such a software-assisted intervention, persuasion and emotion regulation technology. We also shed light on its potential implications from the perspectives of social corporate responsibility and data protection. We finally propose a conceptual architecture to demonstrate our vision and explain how it can be implemented. In the wider context, the paper is meant to provide insights on building behavioural awareness and regulation information systems in relation to problematic digital media usage

Health promotion and disease prevention in the education of health professionals : a mapping of European educational programmes from 2019

Background Health professionals face barriers in carrying out effective health promotion and disease prevention. To indicate what are the needs for curriculum development in educational programmes, this study aims to provide an overview of how various health professionals are currently trained in health promotion and disease prevention at different educational levels. Methods In 2019, a descriptive mapping exercise was performed focusing on European programmes for different health and healthcare professionals at the three levels of education (undergraduate, postgraduate, and continuous professional development [CPD]). Data were collected by a self-developed online survey that was distributed using a modified snowball method. Results A total of 186 educational programmes of 17 different health professionals were analysed, implemented in 31 countries (60% were undergraduate, 30% postgraduate and 10% CPD programmes). Nearly all programmes indicated that expected outcomes were defined on knowledge (99%), skills (94%) and behaviours/attitudes (89%) regarding health promotion and disease prevention. A multidisciplinary approach was reported to be applied by 81% of the programmes. Traditional teaching methods such as lectures (97%) and assignments (81%) were dominant, while e-learning was less frequently used (46%). Digitalization in health promotion and digital health coaching were the least addressed topics in most programmes. Conclusions Health promotion and disease prevention are reported at all surveyed levels of education for a broad spectrum of health professionals. Educational programmes cover contents on knowledge, skills, and behaviours. There is a need for capacity building and joint development in health promotion education. Specifically, there is a need to include digitalisation and novel teaching in the educational programmes of health promotion and disease prevention.Peer reviewe

Is platelet inhibition due to thienopyridines increased in elderly patients, in patients with previous stroke and patients with low body weight as a possible explanation of an increased bleeding risk?

Background The TRITON-TIMI 38 study has identified three subgroups of patients with a higher risk of bleeding during treatment with the thienopyridine prasugrel: patients with a history of stroke or transient ischaemic attack (TIA), patients ≥75 years and patients with a body weight <60 kg. However, the underlying pathobiology leading to this increased bleeding risk remains to be elucidated. The higher bleeding rate may be due to a stronger prasugrelinduced inhibition of platelet aggregation in these subgroups. The aim of the present study was to determine whether on-treatment platelet reactivity is lower in these risk subgroups as compared with other patients in a large cohort on the thienopyridine clopidogrel undergoing elective coronary stenting. Methods A total of 1069 consecutive patients were enrolled. On-clopidogrel platelet reactivity was measured in parallel by light transmittance aggregometry, the Verify- Now®P2Y12 assay and the PFA-100 collagen/ADP cartridge. Results Fourteen patients (1.5%) had a prior history of stroke or TIA, 138 patients (14.5%) were older than 75 years and 30 patients (3.2%) had a body weight <60 kg. Age ≥75 years and a history of stroke were independent predictors of a higher on-treatment platelet reactivity. In contrast, a body weight <60 kg was significantly associated with a lower on-treatment platelet reactivity. Conclusion In two high-risk subgroups for bleeding, patients ≥75 years and patients with previous stroke, onclopidogrel platelet reactivity is increased. In contrast, in patients with a low body weight, on-clopidogrel platelet reactivity is decreased, suggesting that a stronger response to a thienopyridine might only lead to more bleeds in patients with low body weight