Does Motivation for Exercise Influence Post-Exercise Snacking Behavior?

It is well established that regular exercise plays an important role in achieving a number of health and wellbeing outcomes. However, certain post-exercise behaviors, including the consumption of unhealthy high-calorie foods, can counteract some of the benefits of physical activity. There are at least three overlapping pathways through which exercise may increase the likelihood of consuming pleasurable but unhealthy foods: through impulsive cognitive processes, reflective cognitive processes, and/or physiological responses. It is argued in this paper that motivation toward exercise can influence each of these pathways. Drawing from literature from various domains, we postulate that controlled exercise motivation, as opposed to autonomous exercise motivation, is more likely to influence each of these pathways in a manner that leaves individuals susceptible to the post-exercise consumption of pleasurable but unhealthy foods.     

Motivational strategies for physiotherapists

Physical inactivity and non-adherence to physiotherapy are common problems. Physiotherapists as promoters, preventers and rehabilitators are ideally placed to influence physical activity behaviours. Possessing the knowledge and skills to facilitate this behaviour change and to promote adherence to physiotherapy must be viewed as clinical competency. This paper reviews four psychological strategies; self-determination theory, social cognitive theory, cognitive behavioural therapy and motivational interviewing that have been shown to have a positive influence on exercise behaviour. The origins and theoretical model of all four are discussed and an example of an intervention based on each model from the literature is provided. A review of how physiotherapists can use each to inform their practice follows. To conclude the similarities between all four that can be implemented into practice are discussed.     

Dissections of regional lymph nodes for treatment of skin cancer: predicting annual caseloads that will optimise outcomes

IntroductionDissection of regional lymph nodes (RLNs) can lead to significant morbidity and a high prevalence of complications. Published guidance states that these procedures should be carried out by surgeons who are members of a specialist skin multidisciplinary team who carry out a combined minimum of 15 axillary/groin dissections per year. However, there is little evidence to guide this minimum figure of procedures. We report on the burden of service provision and prevalence of complications across the South West of England and Wales.MethodsA 12-month review of dissections of RLNs for skin cancer was undertaken covering five Plastic Surgery Units with a collective catchment of 8.4 million people. Detailed data were collected on patient demographics, pathology, timing of surgery, and prevalence of complications.ResultsA total of 163 dissections were carried out. Forty-three per cent of patients experienced one or more complication. In that 12-month period, an average of 8 axillary/groin dissections was carried out per surgeon. A funnel plot demonstrated that the prevalence of complications for individual surgeons was within the limit of the plot but, in many cases, this was based only on a relatively small number of procedures per consultant. If surgeons carried out 10 procedures per year, the upper and lower limits on the plot were 73% and 11%, respectively.ConclusionsFunnel plots can provide a useful guide as to whether the prevalence of complications for procedures for individual surgeons lies within acceptable limits. Based on these results, 10 procedures per consultant per year should be sufficient to enable meaningful assessment of the prevalence of complications.     

Analysis of steps adapted protocol in cardiac rehabilitation in the hospital phase

Objective

To analyze a cardiac rehabilitation adapted protocol in physical therapy during the postoperative hospital phase of cardiac surgery in a service of high complexity, in aspects regarded to complications and mortality prevalence and hospitalization days.

Methods

This is an observational cross-sectional, retrospective and analytical study performed by investigating 99 patients who underwent cardiac surgery for coronary artery bypass graft, heart valve replacement or a combination of both. Step program adapted for rehabilitation after cardiac surgery was analyzed under the command of the physiotherapy professional team.

Results

In average, a patient stays for two days in the Intensive Care Unit and three to four days in the hospital room, totalizing six days of hospitalization. Fatalities occurred in a higher percentage during hospitalization (5.1%) and up to two years period (8.6%) when compared to 30 days after hospital discharge (1.1%). Among the postoperative complications, the hemodynamic (63.4%) and respiratory (42.6%) were the most prevalent. 36-42% of complications occurred between the immediate postoperative period and the second postoperative day. The hospital discharge started from the fifth postoperative day. We can observe that in each following day, the patients are evolving in achieving the Steps, where Step 3 was the most used during the rehabilitation phase I.

Conclusion

This evolution program by steps can to guide the physical rehabilitation at the hospital in patients after cardiac surgery.     

One-year clinical evaluation of two composite materials used for anterior class V restorations

The purpose of the current study was to evaluate the clinical performance of two composite materials used for filling anterior cavity preparations. A total of 100 class V cavities of anterior tooth were restored with two different composite materials (Palfique Estelite and Palfique Toughwell, 50 cavities each, respectively) in combination with the same bonding agent (Mac Bond II). Colour match, cavosurface marginal discolouration, recurrent caries, wear, marginal integrity and surface texture were evaluated clinically for all restorations on the basis of the United States Public Health Service (USPHS) criteria immediately after insertion (baseline), after 6 months and after 1 year. In the comparison of baseline to 1-year evaluation, the Palfique Toughwell material showed significant changes in all factors except recurrent caries. The Palfique Estelite material, however, showed neither significant cavosurface marginal discolouration nor recurrent caries. No significant difference (P > 0b05) was observed between the two materials in clinical performance after 1 year, with the exception of caries rate, which was found to be significantly lower in the Palfique Estelite material. It was concluded that both composites were clinically reliable materials when used for anterior class V restorations.     

日本《全球健康战略》的实施及其对我国的启示

近年来,全球健康问题已经成为国际社会关注的热点议题和新兴的跨学科领域。2022年5月,日本内阁健康与医疗战略推进本部公布了《全球健康战略》,其意在通过采取相关措施推动建立全球健康体系,加强国际公共卫生危机的预防、防范和应对。通过揭示日本《全球健康战略》发布背景、动因分析和实施路径,以期对我国未来全球健康策略规划提供借鉴。     

认知行为干预结合正面激励对面部瘢痕整形患者心理健康的影响

目的:研究认知行为干预结合正面激励对面部瘢痕整形患者心理健康的影响。方法:纳入2018年1月-2020年4月笔者医院收治的72例面部瘢痕整形患者为研究对象,按照随机数字表法分为对照组(常规护理)及观察组(认知行为干预结合正面激励)。比较两组患者干预前及干预3个月后心理健康[症状自评量表(Symptom checklist 90,SCL-90)]、心理韧性[心理韧性量表(Connor-davidson resilience scale,CD-RISC)]、体象障碍[体象障碍自评量表(Body image rating scale,BIRS)]、躯体自信[躯体自信量表(The body-esteem scale,BES)]、幸福水平[总体幸福感量表(General well-being schedule,GWB)]。结果:干预3个月后,观察组SCL-90、BIRS评分水平明显低于干预前及同期对照组,差异有统计学意义(P<0.05)。干预3个月后,观察组CD-RISC、BES、GWB评分水平明显高于干预前及同期对照组,差异有统计学意义(P<0.05)。结论:认知行为干预结合正面激励能够改善面部瘢痕整形患者心理健康,提升其对自身的信心及幸福感。     

高年资专科护士自我超越驱动力的质性研究

目的 了解高年资专科护士自我超越的促进因素。方法 对15名高年资专科护士就自我超越的动力因素进行深入访谈,对访谈资料采用内容分析法进行归纳和提炼。结果 归纳出2个主题和9个副主题,包括内在驱动力（思维结构改变、个性特征、目标导向、反馈寻求行为、反思与自我激励）和外在驱动力（团队支持、领导授权、外源性压力和社会认可）。结论 促进高年资专科护士自我超越的因素是多方面的,建议护理管理者采取相应措施,重视发挥专科护士的内在动力,优化外力支持环境,以促进专科护理队伍建设。