Alternative medicine and doping in sports

Athletes are high achievers who may seek creative or unconventional methods to improve performance. The literature indicates that athletes are among the heaviest users of complementary and alternative medicine (CAM) and thus may pioneer population trends in CAM use. Unlike non-athletes, athletes may use CAM not just for prevention, treatment or rehabilitation from illness or injuries, but also for performance enhancement. Assuming that athletes'' creative use of anything unconventional is aimed at “legally” improving performance, CAM may be used because it is perceived as more “natural” and erroneously assumed as not potentially doping. This failure to recognise CAMs as pharmacological agents puts athletes at risk of inadvertent doping.The general position of the World Anti-Doping Authority (WADA) is one of strict liability, an application of the legal proposition that ignorance is no excuse and the ultimate responsibility is on the athlete to ensure at all times whatever is swallowed, injected or applied to the athlete is both safe and legal for use. This means that a violation occurs whether or not the athlete intentionally or unintentionally, knowingly or unknowingly, used a prohibited substance/method or was negligent or otherwise at fault. Athletes are therefore expected to understand not only what is prohibited, but also what might potentially cause an inadvertent doping violation. Yet, as will be discussed, athlete knowledge on doping is deficient and WADA itself sometimes changes its position on prohibited methods or substances. The situation is further confounded by the conflicting stance of anti-doping experts in the media. These highly publicised disagreements may further portray inconsistencies in anti-doping guidelines and suggest to athletes that what is considered doping is dependent on the dominant political zeitgeist. Taken together, athletes may believe that unless a specific and explicit ruling is made, guidelines are open to interpretation. Therefore doping risk-taking behaviours may occur because of the potential financial, social and performance gains and the optimistically biased interpretation (that trying alternatives is part of the “spirit of sport”) and doping risk-taking behaviours may occur.This discussion paper seeks to situate the reader in a world where elite level sports and CAM intersects. It posits that an understanding of the underlying motivation for CAM use and doping is currently lacking and that anti-doping rules need to be repositioned in the context of the emerging phenomenon and prevalence of CAM use.     

What do people know about fertility? A systematic review on fertility awareness and its associated factors

Introduction: Recent evidence indicates that reproductive-age people have inadequate fertility awareness (FA) concerning fertility, infertility risk factors, and consequences of delaying childbearing. However, no study has tried to summarize these studies and to clarify the variables associated with FA, namely the role of gender, age, education, and reproductive status on FA.

Methods: A literature search up to February 2017 was conducted using the EBSCO, Web of Science, Scielo, and Scopus electronic databases with combinations of keywords and MeSH terms (e.g. ‘awareness’ OR ‘health knowledge, attitudes, practice’ AND ‘fertility’; ‘fertile period’; ‘assisted reprod*’).

Results: Seventy-one articles met the eligibility criteria and were included. The main results showed that participants report low-to-moderate FA. Higher levels of FA were shown by women, highly educated individuals, people who reported difficulties with conceiving, and those who had planned their pregnancies. Having or desiring to have children was not related to FA level. An inconsistent association between study participant age and FA was observed, with some studies indicating that older participants had higher FA, but others found an opposite result or did not find any association.

Conclusion: The current findings suggest that interventions to increase FA are warranted, especially those targeting men, people with low education, and in family planning settings. Interventions and campaigns should be customized to meet individuals’ needs regarding FA. Because of the high heterogeneity regarding the assessment of FA, these conclusions must be interpreted with caution.     

Public awareness,beliefs and attitude towards depressive disorders in Saudi Arabia

Objectives:To investigate the degree of public awareness, beliefs, and attitudes regarding major depression and available treatment options in the Saudi population.Methods:A community-based cross-sectional study of 1,188 participants was carried out from March to April 2021 in Ha’il, Saudi Arabia using an online self-administered questionnaire. Using a snowball sampling technique, the authors targeted the Saudi population living in Ha’il region.Results:Overall, 65.6% of the participants had good awareness regarding depression disorder in total. Of the participants, 72.9% had good awareness regarding general awareness, 85.4% regarding depression symptoms, 12.3% regarding risk factors, and 15.7% regarding treatments. Of the participants, 67.3% believed that depression was caused by lack of faith and 45.5% believed that depression was caused by “the evil eye” or black magic. Of the participants, 56% believed in faith healers as a legitimate treatment approach. Of the participants, 63.9% were willing to work with individuals with depression, 62.7% were willing to establish friendships with them, and 27.9% believed that individuals with depression had weak personalities.Conclusion:The general population exhibited good general awareness regarding depression and its symptoms, but knowledge of risk factors and treatments was poor. Our findings underscore the need for public educational programs to increase public awareness about the risk factors and treatment options for depression.     

A descriptive study of community-based profile and attitudes of body donors of an urban conglomeration in Western India

BackgroundBody donation is considered an altruistic act done by people for advancement of science. There has been a significant depreciation in the availability of cadavers for teaching and research all over the world. Unlike India, many countries have studied the profile and attitudes of potential body donors to improve body donation. With a huge health sector, this Indian study studied the profile and attitudes of body donors and their role in aiding science through body donation.MethodsFour hundred thirty-one survey forms with informed consent were sent to registered body donors. The questionnaire focused on demographic parameters and their perception on body donation. The data were collated, compared and interpreted with similar studies done worldwide.ResultsThe study shows an interesting pattern among the Indian donors in comparison to the West. An Indian donor is a male individual in 70s, highly educated and religious with good social background. Despite many similarities, there are important distinguishing features unique to our country and many myths surrounding body donation.ConclusionThe Indian donor is highly educated male and charitable with strong belief in God. He believes in aiding medical science through body donation.     

Lack of awareness of oesophageal carcinoma among the public in Ireland

Background  Oesophageal cancer is advanced in the majority at presentation and its symptoms are usually present for many months suggesting poor awareness of its symptoms. Few studies have examined awareness of oesophageal cancer amongst the public. Aims  This study aimed to identify the level of awareness among the general public of oesophageal cancer, of its symptoms, of its awareness campaigns and to compare it with other common cancers. Methods  Face-to-face interviews were conducted with 279 members of the public. People were asked about their awareness of a range of cancers, and their knowledge of cancer symptoms and cancer awareness campaigns. Results  Awareness of oesophageal cancer was low and knowledge of its symptoms was even lower. Despite the efforts of awareness campaigns, knowledge of these campaigns was poor amongst the public. Conclusion  Awareness of oesophageal cancer and its symptoms is low amongst the public. This needs to be addressed if disease is to be detected at an earlier and curable stage.     

Assessing the knowledge,attitude and practice of osteoporosis among Singaporean women aged 65 years and above at two SingHealth polyclinics

INTRODUCTIONSingapore has one of the world’s most rapidly ageing populations. Osteoporosis is associated with significant morbidity and mortality from hip fractures in the elderly. This pilot study aims to evaluate the knowledge, attitude and practice of osteoporosis among Singaporean women aged ≥ 65 years, and assess barriers to osteoporosis screening.METHODSWe conducted a cross-sectional survey of 99 English-speaking women aged ≥ 65 years at two SingHealth polyclinics by convenience sampling. The validated Osteoporosis Prevention and Awareness Tool was used to assess their knowledge about osteoporosis prevention and awareness and perceived barriers to osteoporosis screening. Osteoporosis health education was provided, and bone mineral density (BMD) screening was offered to all participants.RESULTSThe response rate was 91.6%. The majority of the participants (54.5%) had low knowledge of osteoporosis, and only 12.1% had high knowledge scores. Higher education levels were associated with higher knowledge scores (p = 0.018). Although participants with higher knowledge scores were more willing to undergo osteoporosis screening, these findings did not reach statistical significance (p = 0.067). The top reasons for declining BMD testing were misconceptions that lifestyle management is sufficient to prevent osteoporosis, poor awareness and knowledge of the disease, and the perceived high cost of BMD testing.CONCLUSIONInterventions should focus on osteoporosis education and, eventually, BMD screening for less-educated patients. Health education should rectify common misconceptions of the disease, increase awareness of osteoporosis and improve screening rates.     

角色扮演在老年期痴呆患者研究伙伴教育中的应用

目的:探讨角色扮演教育模式提升老年期痴呆患者研究伙伴对痴呆疾病认知的效果.方法:采用临床便利抽样对50名老年期痴呆患者研究伙伴进行每周1次、为期6周的角色扮演教育,应用配对样本t检验对培训前后老年期痴呆患者研究伙伴关于痴呆知识掌握情况以及照护态度的变化进行统计学分析.结果:培训后老年期痴呆患者研究伙伴的痴呆知识评估量表得分(25.58±4.56)高于培训前(17.54±2.68),差异具有统计学意义(P＜0.01);培训后痴呆态度量表得分(109.84±10.82)高于培训前(104.74±11.04),差异具有统计学意义(P＜0.05).结论:角色扮演能有效促进老年期痴呆患者研究伙伴了解患者疾病知识并理解患者的行为模式.     

Awareness of radiation dose associated with common diagnostic procedures in emergency departments: A pilot study

Background

The large number of diagnostic procedures undertaken in emergency departments (ED) is vital to the early diagnosis and treatment of patients. The use of ionising radiation in diagnosis adds a lifetime attributable risk (LAR) of cancer depending on the region imaged, the frequency of imaging, and dose per exposure.

Aims

This pilot study aims to assess the degree of radiation awareness amongst ED doctors at major metropolitan and regional health services in Australia, in terms of the dose and risks associated with common imaging. Secondary aims were to provide a template to practically evaluate ED doctor radiation awareness, identify factors impacting upon radiation awareness (e.g., location, seniority of doctor), and to suggest practical means to improve radiation awareness.

Methods

Physicians in the EDs of two major health services (one regional and one metropolitan) in Australia were surveyed and asked to compare the radiation dose from each procedure to what the general population is exposed to naturally from background radiation. Additionally, the physicians were asked to estimate the LAR of cancer from each diagnostic procedure. These estimates were compared to literature-sourced values to assess the accuracy of physician responses.

Results

Results showed that there was significant variance with regard to knowledge of dose and risk, and that respondents tended to greatly overexaggerate the radiation levels and risk associated with diagnostic imaging. Despite failing to attribute correct values, in many cases, respondents ranked scans correctly. Responses comparing differences amongst the two health services and amongst different levels of medical hierarchy largely overlapped with no clear difference between these factors.

Conclusion

Physicians reported low confidence in their knowledge of radiation awareness and indicated the need for additional education, which would assist them in communicating the risks to patients. Furthermore, such education would assist physicians in tailoring their diagnostic imaging requests so as to minimise radiation levels in patients.     

Physician awareness and attitudes regarding early warning score systems in mainland China: a cross-sectional study

INTRODUCTIONThe purpose of this study was to assess the application of the early warning score system (EWS-S) and gauge physician awareness, perceptions of necessity and attitudes regarding these tools based on previously experienced unnoticed clinical deterioration (CDET).METHODSA cross-sectional survey was carried out via an online questionnaire at a large 3,500-bed Class 3A general hospital in China. A total of 299 physicians of adult general wards were asked to answer a translated questionnaire that was localised from the original version. Demographic profiles of patients were included as well as three other sections assessing awareness of CDET/EWS-S and gauging attitudes towards and perceptions of the necessity of EWS-S at our hospital.RESULTSA high level of physician awareness of the CDET problem was observed. Most physicians knew about the existence of a systematic assessment tool for clinical application. Physicians with previous experience in reanimation, unplanned transfer to intensive care unit (UTICU) and/or death tended to consider EWS-S necessary in attentive and well-trained staff (p < 0.05). Physicians who had previous experience with UTICU were more likely to recommend implementing EWS-S in their wards compared with those without such experience (p < 0.05).CONCLUSIONMost physicians have positive attitudes towards EWS-S. However, their awareness should be further heightened. Physicians who had previous experience with CDET/UTICU were more likely to employ EWS-S in their clinical practices. To better facilitate the implementation of EWS-S in Chinese hospitals, existing facilities, policy supports, standardised managements and the development of information systems should be strengthened.     

Folic acid knowledge and use among relatives in Irish families with neural tube defects: An intervention study

Background Relatives in families where a child has a neural tube defect (NTD) may be at higher risk of having an affected child. Little is known of their level of knowledge and use of folic acid. Aim To carry out an intervention study intended to increase knowledge and use of folic acid among relatives. Methods One hundred aunts and female first cousins (relatives of the proband) were interviewed by telephone before and after receiving an information pack. Results At baseline, although knowledge of the benefits of folic acid was high (73%), use of folic acid was low (8.8%). After the intervention, knowledge increased and use went up to 19% (p<0.05). Conclusions This study suggests that relatives in Irish NTD families have a high level of information about folic acid benefits. This awareness may not translate into action since the intervention produced only a modest increase in folic acid use overall. Future studies focussing on women who are planning a pregnancy may show larger benefits from intervention.     

基于文献的干燥综合征方药关联分析研究

[目的]利用数据挖掘技术分析干燥综合征的用药规律,为临床辨治决策提供依据。[方法]收集近20多年现代医家治疗干燥综合征的医案文献,采用频数统计分析和关联分析方法,在对现代医家医案按证型分类基础上进行关联分析,探讨治疗干燥综合征的用药规律。[结果]阴虚津亏型中北沙参、麦门冬、生地、石斛、玄参之间存在着明显的用药配伍规律,气阴两虚型中生地、玄参、北沙参、玉竹、麦门冬、生黄芪之间存在着明显的用药配伍规律,阴虚血瘀型中桃仁、红花、生地、白芍、麦门冬、石斛、玄参、当归之间存在着明显的用药配伍规律,肝肾阴虚型中北沙参、麦门冬、生地、生甘草、山茱萸、生山药之间存在着明显的用药配伍规律。[结论]通过数据挖掘方法,可以探明干燥综合征文献中用药组方规律,为临床决策提供依据,也为进一步中医标准化研究提供线索。     

Development of an evidence-based website on preconception health

Introduction: Many women and men lack knowledge about fertility, including timing of the fertile window, age-related decline, and lifestyle factors that may impair fertility. The Internet has become an important source of information, but evidence-based information on fertility and reproduction in Swedish on the Internet is limited. The present study aimed to develop and evaluate an evidence-based fertility awareness website, ‘reproduktivlivsplan.se’, to increase awareness of fertility and provide guidance for improved preconception health and care among individuals and healthcare providers.

Methods: The website’s content, design, and layout were evaluated qualitatively among a total of 20 nursing students. An expert group of researchers also provided feedback on the content. Finally, healthcare providers (n?=?24) answered a questionnaire covering attitudes and views on the Reproductive Life Plan website as a tool for counselling.

Results: The developing process resulted in a mobile-friendly website, ‘reproduktivlivsplan.se’ (in English: Reproductive Life Plan). The website, including the content and layout, was positively evaluated by most participants and was amended according to suggested improvements. Uppsala University was found to be a trustworthy source.

Conclusion: The evidence-based website ‘reproduktivlivsplan.se’ was well received among users and healthcare providers and may provide guidance for improved preconception health and care if it becomes well known and frequently used.     

Knowledge,attitude, and practices related to cutaneous leishmaniasis in an endemic focus of cutaneous leishmaniasis,Southern Iran

ObjectiveTo assess knowledge, attitudes, and practices (KAP) of inhabitants of an endemic area in Fars province toward cutaneous leishmaniasis (CL).MethodsThe study was carried out in Lapui district in Fars province, south of Iran, one of the most important foci of CL in this province. Sample size (237 residents) was calculated based on population. House-to-house survey was done to collect the data regarding knowledge, attitudes, and practices of the inhabitants. The head of each household was interviewed by a trained staff to assess his/her KAP related to CL. A semi-structured KAP questionnaire was used for data collection.ResultsMean age of participants was 39 and more than half of the respondents were in the age group of 31-40. Males constituted 172 (72.5%) of subjects. Most of the respondents (84.3%) were literate. The majority of the study population (83%) had heard about Salak (local name for CL) and most of these respondents (91%) were aware that CL is presented with a cutaneous lesion. Nearly two-third of the participants (63.5%) stated the bite of mosquito (not specifically sandflies) for CL transmission. The respondents’ attitude regarding the treatment of CL was not satisfactory since only 48% believed that CL can be treated by medicine. A noticeable proportion of respondents (21%) believed in indigenous medicine for the treatment of CL. A small proportion of respondents (14%) stated that traditional healers are good at treating this disease. More than two-third (69%) of respondents believed that the disease is preventable although most of interviewees did not know about preventive measures.ConclusionsIn this study, insufficient knowledge of community about infection nature, vector, transmission mode and preventive measures of CL, highlights the needs for a health education initiative to enhance the awareness of people about CL. This would improve inhabitants’ contribution in control program of CL in this area.     

Awareness of head and neck cancers in Saudi Arabia: A questionnaire based study

Objectives:To address the gap in knowledge by providing data and analyses of the status of awareness among Saudi adults.Methods:This cross-sectional questionnaire-based study was carried out in Saudi Arabia from August 2018 to August 2019 through social media platforms using SurveyMonkey. The domains of the questionnaire included demographic information, knowledge of types and symptoms of head and neck cancers (HNCs), and the relation of HNCs to human papillomavirus (HPV) and its vaccine.Results:A total of 3171 respondents completed the questionnaire. The analysis revealed that many of the study respondents (49.3%) were not knowledgeable about HNCs. Almost two-thirds (61.2%) of the study population incorrectly believed that brain cancer was included in HNCs. Over half (57.8%) did not recognize headaches as a symptom. In terms of the risk factors, males showed higher awareness of tobacco and excessive alcohol as risk factors, while females were more knowledgeable about HPV infection (p<0.05).Conclusion:This study revealed that there is a lack of knowledge and awareness of the clinical features of and risk factors for HNCs among the Saudi population.