The Content Validity of the Items Related to the Social and Spiritual Dimensions of the Utrecht Symptom Diary-4 Dimensional From a Patient's Perspective: A Qualitative Study.

CONTEXT: In palliative care, caregivers often lack words and competences to discuss patients' needs in social and spiritual dimensions. The Utrecht Symptom Diary-4 Dimensional (USD-4D) is an instrument that can be used to monitor symptoms and needs in the physical, psychological, social, and spiritual dimensions and to optimize communication between patients and caregivers. OBJECTIVE: To assess the content validity of the USD-4D items related to the social and spiritual dimensions from a patient's perspective, measured in terms of comprehensibility, relevance, and comprehensiveness. METHODS: An explorative qualitative study was conducted using in-depth semistructured interviews and thematic analysis. Twelve participants (male N = 7, 53-87 years old) with an estimated life expectancy of less than one year were recruited in two home care services: a general hospital and a hospice. RESULTS: The instructions, items, and response options were comprehensible for almost all participants. The meaning that was provided to the items was expressed in themes: maintaining personal identity and autonomy, resilience, letting go, perceived balance in one's life, and death and afterlife. This corresponds with the intended meaning. The items were relevant at some points in time. Not all participants had needs for personal care during the interviews. Participants found the USD-4D comprehensive, no key concepts related to the social or spiritual dimensions appeared to be missing. CONCLUSIONS: The USD-4D constitutes a content valid PROM from the patient's perspective. The items support patients in identifying needs in the social and spiritual dimensions and in the conversation to further explore these needs.

Sinergia educación, prevención, promoción de salud comunitaria desde el paradigma de la sociocultura / Synergy between education, prevention, promotion of community health from the sociocultural paradigm / Sinergia educação, prevenção, promoção da saúde comunitaria desde o paradigma socio-cultural

Resumen Objetivo: Analizar la sinergia de la educación, prevención y promoción de la salud concebida como una construcción sociocultural mediada por las prácticas culturales que desarrollan las personas de una comunidad cubana durante los años 2013-2017. Materiales y Métodos: Estudio de caso único que combina las perspectivas cuantitativa y cualitativa de investigación, con el empleo de la observación participante, cuestionarios, entrevistas en profundidad en el escenario comunitario y la consulta a expertos, además de los procedimientos teóricos analítico-sintético, así como la inducción y deducción. Resultados: Los resultados revelan la existencia de prácticas culturales comunitarias relacionadas con la salud, en las que se produce una simbiosis de la educación, prevención y promoción de salud como elementos esenciales del proceso salud-enfermedad. Conclusiones: El contexto comunitario en que se desarrolla el proceso salud-enfermedad está mediado por prácticas culturales, lo que propicia la concepción de la salud como una construcción sociocultural inherente a la actividad humana, la cual debe garantizarse mediante la educación, prevención y promoción de salud concebidas como todo un sistema integrado.

Abstract Objective: To analyze the synergy between education, prevention and promotion of health conceived as a sociocultural construction mediated by the cultural practices developed by people of a Cuban community during the years 2013-2017. Materials and Methods: Single case study that combines the quantitative and qualitative perspectives of research with the use of participant observation, questionnaires, in- depth interviews in the community setting and the consultation to experts, besides the analytic-synthetic theoretical procedures, as well as induction and deduction. Results: The results reveal the existence of community cultural practices related to health in which a symbiosis between education, prevention and promotion of health as essential elements of the health-disease process is produced. Conclusions: The community context in which the health-disease process takes place is mediated by cultural practices which favors the conception of health as an sociocultural construction inherent to the human activity, which must be guaranteed through education, prevention and promotion of health conceived as an entire integrated system.

Resumo Objetivo: Analisar a sinergia da educação, prevenção e promoção da saúde concebida como uma construção sociocultural mediada pelas práticas culturais que desenvolvem as pessoas duma comunidade cubana durante os anos 2013-2017. Materiais e Métodos: Estudo de caso único que mistura as perspectivas quantitativa e qualitativa de pesquisa, com o emprego da observação participante, questionários, entrevistas em profundidade no cenário comunitário e a consulta a expertos, além dos procedimentos teóricos analítico-sintético, assim como a indução e dedução. Resultados: Os resultados revelam a existência de práticas culturais comunitárias relacionadas com a saúde, nas que se produze uma simbioses da educação, prevenção e promoção de saúde como elementos essenciais do processo saúde- doença. Conclusões: O contexto comunitário no que se desenvolve o processo saúde-doença está mediado por práticas culturais, o que propicia a concepção da saúde como uma construção sociocultural inerente à atividade humana, a qual deve garantir-se mediante a educação, prevenção e promoção de saúde concebidas como um sistema integrado.

Sinergia educación, prevención, promoción de salud comunitaria desde el paradigma de la sociocultura / Synergy between education, prevention, promotion of community health from the sociocultural paradigm / Sinergia educação, prevenção, promoção da saúde comunitaria desde o paradigma socio-cultural

Objetivo: Analizar la sinergia de la educación, prevención y promoción de la salud concebida como una construcción sociocultural mediada por las prácticas culturales que desarrollan las personas de una comunidad cubana durante los años 2013-2017. Materiales y Métodos: Estudio de caso único que combina las perspectivas cuantitativa y cualitativa de investigación, con el empleo de la observación participante, cuestionarios, entrevistas en profundidad en el escenario comunitario y la consulta a expertos, además de los procedimientos teóricos analítico-sintético, así como la inducción y deducción. Resultados: Los resultados revelan la existencia de prácticas culturales comunitarias relacionadas con la salud, en las que se produce una simbiosis de la educación, prevención y promoción de salud como elementos esenciales del proceso salud-enfermedad. Conclusiones: El contexto comunitario en que se desarrolla el proceso salud-enfermedad está mediado por prácticas culturales, lo que propicia la concepción de la salud como una construcción sociocultural inherente a la actividad humana, la cual debe garantizarse mediante la educación, prevención y promoción de salud concebidas como todo un sistema integrado.

Objective: To analyze the synergy between education, prevention and promotion of health conceived as a sociocultural construction mediated by the cultural practices developed by people of a Cuban community during the years 2013-2017. Materials and Methods: Single case study that combines the quantitative and qualitative perspectives of research with the use of participant observation, questionnaires, indepth interviews in the community setting and the consultation to experts, besides the analytic-synthetic theoretical procedures, as well as induction and deduction. Results: The results reveal the existence of community cultural practices related to health in which a symbiosis between education, prevention and promotion of health as essential elements of the health-disease process is produced. Conclusions: The community context in which the health-disease process takes place is mediated by cultural practices which favors the conception of health as an sociocultural construction inherent to the human activity, which must be guaranteed through education, prevention and promotion of health conceived as an entire integrated system.

Objetivo: Analisar a sinergia da educação, prevenção e promoção da saúde concebida como uma construção sociocultural mediada pelas práticas culturais que desenvolvem as pessoas duma comunidade cubana durante os anos 2013-2017. Materiais e Métodos: Estudo de caso único que mistura as perspectivas quantitativa e qualitativa de pesquisa, com o emprego da observação participante, questionários, entrevistas em profundidade no cenário comunitário e a consulta a expertos, além dos procedimentos teóricos analítico-sintético, assim como a indução e dedução. Resultados: Os resultados revelam a existência de práticas culturais comunitárias relacionadas com a saúde, nas que se produze uma simbioses da educação, prevenção e promoção de saúde como elementos essenciais do processo saúde- doença. Conclusões: O contexto comunitário no que se desenvolve o processo saúde-doença está mediado por práticas culturais, o que propicia a concepção da saúde como uma construção sociocultural inerente à atividade humana, a qual deve garantir-se mediante a educação, prevenção e promoção de saúde concebidas como um sistema integrado.

Medical care in unlicensed combat sports: A need for standardised regulatory frameworks.

OBJECTIVES: To explore the provision of medical care at 'unlicensed', full-contact amateur and lower-level professional combat sports competitions in England. DESIGN: Qualitative, mixed methods. METHODS: Observations totalling 200h of fieldwork shadowing medical professionals at 27 individual combat sports events, alongside formal, semi-structured interviews with 25 medical professionals, 7 referees and 9 promoters/event staff. RESULTS: Practices and standards vary widely. Event organisers and promoters often have very little understanding of how different types of medical practitioners operate. They rarely, if ever, check that the staff they are hiring are qualified, sometimes resulting in unqualified staff being used to provide medical cover at events. Venues are often poorly equipped to accommodate basic medical procedures. Patient confidentiality is very often compromised. Medical professionals often have limited autonomy within the combat sports milieu and may find themselves marginalised, with their judgements overruled by non-medical staff during competitive events. Some practitioners are cognisant of the dangers such working environments pose to their professional reputations and livelihoods, but remain working within combat sports regardless. CONCLUSIONS: Despite pockets of good practice, the lack of standardised rules for medical care provision creates substantial risks to athletes, to practitioners and the standing of the profession. The development and implementation of standardised, enforceable regulatory frameworks for full-contact combat sports in England is urgently needed.

Mais do que uma "questão de peso": análise do conteúdo dos discursos de rivalidade entre as lutadoras de MMA (Mixed Martial Arts) Ronda Rousey e Cris Cyborg / More than a "weight issue": analysis of the content of rivalry discourses between MMA (Mixed Martial Arts) fighters Ronda Rousey and Cris Cyborg / Más que una "cuestión de peso": análisis del contenido de los discursos de rivalidad entre las luchadoras de MMA (Mixed Martial Arts) Ronda Rousey y Cris Cyborg

Resumo: O objetivo desse artigo é identificar e analisar o conteúdo dos discursos de rivalidade entre duas lutadoras de MMA­ Ronda Rousey e Cris Cyborg ­ veiculados pelo website da revista Tatame. A partir da análise de conteúdo proposta por Bardin (2009), foram identificadas 77 unidades de registro e 11 categorias. Após análise foi possível concluir que a disputa que poderá se materializar no ringue e o teor dos discursos que a antecede são reflexo da posição que cada uma das agentes ocupa na estrutura campo esportivo e no subcampo do MMA. (AU)

Abstract: This article identifies and analyzes the content of rivalry discourses between two MMA fighters ­ Ronda Rousey and Cris Cyborg ­ conveyed on the website of Tatame magazine. Using content analysis proposed by Bardin (2009), 77 recording units and 11 categories were identified. After analysis, we concluded that the dispute that may take place in the ring and the content of speeches that precede it reflect the position of each of the actors in the sports field structure and in the MMA subfield. (AU)

Resumen: El objetivo de este artículo es identificar y analizar el contenido de los discursos de rivalidad entre dos luchadoras de MMA ­Ronda Rousey y Cris Cyborg­ difundidos por la web de la revista Tatame. A partir del análisis de contenido propuesto por Bardin (2009), se identificaron 77 unidades de registro y 11 categorías. Tras el análisis, se concluyó que la controversia que podrá materializarse en el ring, y la tónica de los discursos que la precede, es un reflejo de la posición que cada una de las agentes ocupa en la estructura del campo deportivo y en el subcampo del MMA. (AU)

Complementary medicine use by the Australian population: a critical mixed studies systematic review of utilisation, perceptions and factors associated with use.

BACKGROUND: There is increasing evidence that complementary medicine (CM) services are being used by a substantial proportion of the Australian population and this topic has attracted keen interest from primary health care providers and policy makers. This article outlines the first summative critical review of the predictors of CM use in Australia as well as the characteristics and perceptions of Australian CM users over the last 14 years. METHODS: A literature search was conducted to ascertain original research from 2000 to 2014 in the AMED; CINAHL; and PubMed databases. Selected articles were subject to a critical appraisal analysis to identify the quality of the article. The search was confined to peer reviewed original articles published in English which identified the nature of CM services use in Australia. RESULTS: The findings indicate a correlation between CM users and gender, with reports of a higher rate of use from females compared to males. Female CM users are more likely to be middle-aged with a higher education and higher annual income in comparison to female non-CM users. An association between resident location and use of CM disciplines was also identified with reports of rural residents utilising manual therapies more frequently compared to urban residents. CM users are more likely to seek CM services for a range of chronic conditions including diseases identified as National Health Priority Areas by the Australian Government. CONCLUSIONS: This article provides the first comprehensive review examining the nature of CM use in Australia. The review findings offer important insights into the characteristics and features of CM use in Australia and provide insights for national and regional primary health care initiatives and of interest to medical doctors, allied health professionals, CM practitioners, researchers and policy makers.