Patients’ Attitude toward Breaking Bad News; a Brief Report

Introduction: Delivering bad news is a stressful moment for both physicians and patients. The purpose of this investigation was to explore the patients’ preferences and attitudes toward being informed about the bad news. Methods: This cross-sectional study was done on patients admitted to Imam Khomeini Hospital, Sari, Iran, from September 2014 to February 2015. Patient attitude regarding breaking bad news was evaluated using a reliable and valid questionnaire. Results: 130 patients were evaluated (61.5% male, mean age = 46.21 ± 12.1 years). 118 (90.76%) participants believed that the patient himself/herself should be informed about the disease’s condition. 120 (92.30%) preferred to hear the news from a skillful physician and 105 (80.76%) believed that emergency department is not a proper place for breaking bad news. Conclusion: Based on the results of the present study, most participants believed that the most experienced and skillful physician should inform them completely regarding their medical condition. At the same time they declared that, it is best to hear bad news in a calm and suitable place and time rather than emergency department or hospital corridors during teaching rounds

Perceptions of the Supportive Role Supervisor and Coworker in Proactive Behavior

the researchers used standard questionnaires that had already been approved for their reliability and validity to the study field, ie Ilam Power Distribution Company to distribute and collect the desired meter. Data analysis was performed using structural equation modeling based on the least squares approach using Smart PLS software. The results showed that all the relationships of the drawn path have been confirmed in the conceptual model. Accordingly, perceived organizational support and the support of perceived colleagues have a positive and significant relationship in the occurrence of pioneering behaviors and atmosphere. Also, the relationship atmosphere has a positive and significant effect on the emergence of pioneering behaviors of the company's employees. Finally, perceived organizational support and perceived peer support through the relationship variable have a positive and indirect effect on the emergence of pioneering behaviors. The results of this research will have innovations in the field of reflecting pioneering behaviors in the organization environment and will help managers and employees in understanding and introducing such behaviors and their causes as motivators of pioneering action

Can lower extremity anatomical measures and core stability predict dynamic knee valgus in young men?

Introduction: Dynamic knee valgus (DKV) is a risk factor for lower extremity injuries such as anterior cruciate ligament and patellofemoral pain syndrome. Purpose of the current study was to investigate the relationship between lower extremity anatomical measures (LEAM) and core stability with DKV during the single-leg squat. Methods: Thirty healthy men aged between 18 and 28 years participated in this cross-sectional biomechanical study. DKV was assessed using a 6-camera motion analysis system during a single-leg squat task. Anteversion of hip, hip internal and external rotation, Q-angle, knee hyperextension, tibial torsion, tibia vara, plantar arch index, and core stability were measured using standard clinical procedures. To predict DKV, a multiple linear regression model was used. Result: The stability index negatively and plantar arch index positively predicted greater DKV during the single-leg squat task (P = 0.001 and P = 0.09, respectively). Research variables together predicted 82% of the variance in DKV (F(4,26) = 28.09, p < 0.001). However, relationships between other variables and DKV were not found. Conclusion: The core stability index and plantar arch index were associated with observed DKV during the single-leg squat. These results suggested that proximal and distal variables to the knee should be considered when evaluating individuals who present DKV during the single-leg squat. (C) 2021 Elsevier Ltd. All rights reserved

Quantifying lower limb inter-joint coordination and coordination variability after four-month wearing arch support foot orthoses in children with flexible flat feet

Introduction: Flat feet in children negatively affect lower limb alignment and cause adverse health-related problems. The long-term application of foot orthoses (FOs) may have the potential to improve lower limb coordination and its variability. Aim: To evaluate the effects of long-term use of arch support FOs on inter-joint coordination and coordination variability in children with flexible flat feet. Methods: Thirty boys with flexible flat feet were randomly assigned to the experimental (EG) and control groups. The EG used medial arch support FOs during daily activities over a four-month period while the control group received a flat 2-mm-thick insole for the same time period. Lower-limb coordination and variability during the 3 sub-stance phases were quantified using a vector coding technique. Results: Frontal plane ankle-hip coordination in EG during mid-stance changed to an anti-phase pattern (156.9) in the post-test compared to an in-phase (221.1) in the pre-test of EG and posttest of CG (222.7). Frontal plane knee-hip coordination in EG during loading response (LR) changed to an anti-phase pattern (116) in the post-test compared to an in-phase (35.5) in the pre-test of EG and post-test of CG (35.3). Ankle inversion/eversion-knee internal/external rotation joint coupling angle in EG changed to an in-phase pattern (59) in the post-test compared to a proximal phase (89) in the pre-test. Coupling angle variability increased in the post-test of EG for sagittal plane ankle-hip during push-off, transverse plane ankle-hip during LR and mid-stance, and transverse plane knee-hip during LR and mid-stance compared to pre-test of EG and post-test of CG. Conclusion: The long-term use of arch support FOs proved to be effective to alter lower limb coordination and coordination variability during walking in children with flexible flat feet. This new insight into coordinative function may be useful for improving corrective exercise strategies planned for children with flat feet

Factors Associated With Lower Limb Injuries in Recreational Runners:A Cross-Sectional Survey Including Mental Aspects and Sleep Quality

Knowledge about prevalence and etiology of running-related injuries (RRIs) is important to design effective RRI prevention programs. Mental aspects and sleep quality seem to be important potential risk factors, yet their association with RRIs needs to be elucidated. The aims of this study are to investigate the epidemiology of RRIs in recreational runners and the association of mental aspects, sleep, and other potential factors with RRIs. An internet-based questionnaire was sent to recreational runners recruited through social media, asking for personal and training characteristics, mental aspects (obsessive passion, motivation to exercise), sleep quality, perceived health, quality of life, foot arch type, and RRIs over the past six months. Data were analyzed descriptively and using logistic regression. Self-reported data from 804 questionnaires were analyzed. Twenty-five potential risk factors for RRIs were investigated. 54% of runners reported at least one RRI. The knee was the most-affected location (45%), followed by the lower leg (19%). Patellofemoral pain syndrome was the most-reported injury (20%), followed by medial tibial stress syndrome (17%). Obsessive passionate attitude (odds ratio (OR):1.35; 95% confidence interval (CI):1.18-1.54), motivation to exercise (OR:1.09; CI:1.03-1.15), and sleep quality (OR:1.23; CI:1.15-1.31) were associated with RRIs, as were perceived health (OR:0.96; CI:0.94-0.97), running over 20 km/week (OR:1.58; CI:1.04-2.42), overweight (OR:2.17; CI:1.41-3.34), pes planus (OR:1.80; CI:1.12-2.88), hard-surface running (OR:1.37; CI:1.17-1.59), running company (OR:1.65; CI:1.16-2.35), and following a training program (OR:1.51; CI:1.09-2.10). These factors together explained 30% of the variance in RRIs. A separate regression analysis showed that mental aspects and sleep quality explain 15% of the variance in RRIs. The association of mental aspects and sleep quality with RRIs adds new insights into the multifactorial etiology of RRIs. We therefore recommend that besides common risk factors for RRI, mental aspects and sleep be incorporated into the advice on prevention and management of RRIs

Corrigendum to "Quantifying lower limb inter-joint coordination and coordination variability after four-month wearing arch support foot orthoses in children with flexible flat feet" [Human Movement Science 70 (2020) 102593]

The authors regret: The first line under section 2.4 Calculation of coordination and coordination variability should read: • ‘The following equations are based on the step by step approach devised and reported by Needham et al. (2014)’. • Cite Chang et al. (2008) in addition to Sparrow et al. (1987) for equation, 4. Chang et al. (2008) already cited in paper. • Cite Batschelet (1981) in addition to Hamill et al., (2000). Batschelet, E., 1981. Circular Statistics in Biology. Academic Press, New York. The authors would like to apologise for any inconvenience caused.</p

The effect of changing mediolateral center of pressure on rearfoot eversion during treadmill running

INTRODUCTION: Atypical rearfoot eversion is an important kinematic risk factor in running-related injuries. Prominent interventions for atypical rearfoot eversion include foot orthoses, footwear, and taping, yet a running gait retraining is lacking. Therefore, the aim was to investigate the effects of changing mediolateral center of pressure (COP) on rearfoot eversion, subtalar pronation, medial longitudinal arch angle (MLAA), hip kinematics and vertical ground reaction force (vGRF). METHODS: Fifteen healthy female runners underwent gait retraining under three conditions. Participants were instructed to run normally, on the lateral (COP lateral) and medial (COP medial) side of the foot. Foot progression angle (FPA) was controlled using real-time visual feedback. 3D measurements of rearfoot eversion, subtalar pronation, MLAA, FPA, hip kinematics, vGRF and COP were analyzed. A repeated-measures ANOVA followed by pairwise comparisons was used to analyze changes in outcome between three conditions. Data were also analyzed using statistic parameter mapping. RESULTS: Running on the lateral side of the foot compared to normal running and running on the medial side of the foot reduced peak rearfoot eversion (mean difference (MD) with normal 3.3°, p < 0.001, MD with COP medial 6°, p < 0.001), peak pronation (MD with normal 5°, p < 0.001, MD with COP medial 9.6°, p=<0.001), peak MLAA (MD with normal 2.3°, p < 0.001, MD with COP medial 4.1°, p < 0.001), peak hip internal rotation (MD with normal 1.8°, p < 0.001), and peak hip adduction (MD with normal running 1°, p = 0.011). Running on the medial side of the foot significantly increased peak rearfoot eversion, pronation and MLAA compared to normal running. SIGNIFICANCE: This study demonstrated that COP translation along the mediolateral foot axis significantly influences rearfoot eversion, MLAA, and subtalar pronation during running. Running with either more lateral or medial COP reduced or increased peak rearfoot eversion, peak subtalar pronation, and peak MLAA, respectively, compared to normal running. These results might use as a basis to help clinicians and researchers prescribe running gait retraining by changing mediolateral COP for runners with atypical rearfoot eversion or MLAA

The effect of changing foot progression angle using real-time visual feedback on rearfoot eversion during running

Atypical rearfoot in/eversion may be an important risk factor for running-related injuries. Prominent interventions for atypical rearfoot eversion include foot orthoses, footwear, and taping but a modification derived from gait retraining to correct atypical rearfoot in/eversion is lacking. We aimed to investigate changes in rearfoot in/eversion, subtalar pronation, medial longitudinal arch angle, and selected lower limb joint biomechanics while performing toe-in/toe-out running using real-time visual feedback. Fifteen female runners participated in this study. Subjects performed toe-in/toe-out running using real-time visual feedback on foot progression angle, which was set ±5° from habitual foot progression angle. 3D kinematics of rearfoot in/eversion, subtalar supination/pronation, medial longitudinal arch angle, foot progression angle, hip flexion, ab/adduction and internal/external rotation, knee flexion, ankle dorsiflexion, and ankle power were analyzed. A repeated-measures ANOVA followed by pairwise comparisons was used to analyze changes between three conditions. Toe-in running compared to normal and toe-out running reduced peak rearfoot eversion (mean difference (MD) with normal = 2.1°; p<0.001, MD with toe-out = 3.5°; p<0.001), peak pronation (MD with normal = -2.0°; p<0.001, MD with toe-out = -3.4; p = <0.001), and peak medial longitudinal arch angle (MD with normal = -0.7°; p = 0.022, MD with toe-out = -0.9; p = 0.005). Toe-out running significantly increased these kinematic factors compared to normal and toe-in running. Toe-in running compared to normal running increased peak hip internal rotation (MD = 2.3; p<0.001), and reduced peak knee flexion (MD = 1.3; p = 0.014). Toe-out running compared to normal running reduced peak hip internal rotation (MD = 2.5; p<0.001), peak hip ab/adduction (MD = 2.5; p<0.001), peak knee flexion (MD = 1.5; p = 0.003), peak ankle dorsiflexion (MD = 1.6; p<0.001), and peak ankle power (MD = 1.3; p = 0.001). Runners were able to change their foot progression angle when receiving real-time visual feedback for foot progression angle. Toe-in/toe-out running altered rearfoot kinematics and medial longitudinal arch angle, therefore supporting the potential value of gait retraining focused on foot progression angle using real-time visual feedback when atypical rearfoot in/eversion needs to be modified. It should be considered that changes in foot progression angle when running is accompanied by changes in lower limb joint biomechanics

Strengthening the primary health care system in the face of emerging and re-emerging epidemics — provide a native and Applicable model based on best practices of countries

INTRODUCTION: Disasters affected the primary health care system in many ways. Maintaining primary health care services is a challenging issue during disasters such as epidemics. A review was conducted to study the lessons learned and successful experiences of other countries in opposing the spread of infectious diseases using the capacity of primary health care. MATERIAL AND METHODS: The present study is a comprehensive review of countries’ experiences, successful models, and structural components for development of a model for Iran. A systematic search with suitable keywords was conducted in many databases including web of science, PubMed, Scopus, Science Direct, Google Scholar, and Persian databases; Magiran, and SID. RESULTS: The results showed that generally, the successful actions of countries in case of emergency are divided into disaster cycles including preparedness, response, and recovery. PHC can help health systems to identify new epidemics through surveillance system as an early warning system. Because of the importance of continuity of care in primary health care facilities, business continuity plans are needed. CONCLUSIONS: In order to use the consequences and play an effective role in this field, Iran should use the country’s capacity and inter-sectoral cooperation to establish a comprehensive system for telemedicine programs Providing people with doctors and health professionals can strengthen the performance of the primary health care system finally can strengthen the performance of the primary health care system