The #longcovid revolution: A reflexive thematic analysis.

Research has identified long COVID as the first virtual patient-made condition (Callard and Perego, 2021). It originated from Twitter users sharing their experiences using the hashtag #longcovid. Over the first two years of the pandemic, long COVID affected as many as 17 million people in Europe (WHO, 2023). This study focuses on the initial #longcovid tweets in 2020 (as previous studies have focused on 2021-2022), from the first tweet in May to August 2020, when the World Health Organization recognised the condition. We collected over 31,000 tweets containing #longcovid from Twitter. Using Braun and Clarke's reflexive thematic analysis (2020), informed by the first author's experience of long COVID and drawing on Ian Hacking's perspective on social constructionism (1999), we identified different grades of social constructionism in the tweets. The themes we generated reflected that long COVID was a multi-system, cyclical condition initially stigmatised and misunderstood. These findings align with existing literature (Ladds et al., 2020; Rushforth et al., 2021). We add to the existing literature by suggesting that Twitter users raised awareness of long COVID by providing social consensus on their long COVID symptoms. Despite the challenge for traditional evidence-based medicine to capture the varied and intermittent symptoms, the social consensus highlighted that these variations were a consistent and collective experience. This social consensus fostered a collective social movement, overcoming stigma through supportive tweets and highlighting their healthcare needs using #researchrehabrecognition. The #longcovid movement's work was revolutionary, as it showed a revolutionary grade of social constructionism, because it brought about real-world change for long COVID sufferers in terms of recognition and the potential for healthcare provisions. Twitter users' accounts expose the limitations of traditional evidence-based medicine in identifying new conditions. Future research on novel conditions should consider various research paradigms, such as Evidence-Based Medicine Plus (Greenhalgh et al., 2022).

Eficacia de un programa de estilo de vida de salud en Chile / Efficacy of a Lifestyle Health Program in Chile

Introducción: La situación de salud en Chile frente a las enfermedades crónicas no transmisibles ha empeorado en los últimos años. Por ello, son necesarios programas de cambio de hábitos que promuevan factores protectores y disminuyan factores de riesgo cardiovascular, y así intervenir desde donde surge el problema. Objetivo: Evaluar la eficacia del programa Consultores de Salud Familiar mediante un trabajo de seguimiento de los indicadores de salud medidos. Métodos: Estudio analítico, cuasiexperimental y longitudinal. Se llevó a cabo en las ciudades de Concepción y Temuco, Chile, y se realizaron las mediciones de indicadores biométricos (IMC, peso, porcentaje de grasa corporal, porcentaje de músculo esquelético, nivel de grasa visceral, presión arterial sistólica y diastólica, perímetro de cintura y glucemia) en dos planes de seguimiento (general de un mes y personalizado, dos meses). Resultados: Al comparar ambos planes, se observó que en el plan de seguimiento general existieron diferencias en peso, porcentaje grasa corporal, porcentaje músculo esquelético e IMC (p < 0,01), y en el plan de seguimiento personalizado se observaron diferencias en presión arterial sistólica, perímetro de cintura, peso, porcentaje grasa corporal e IMC (p < 0,01) y glucemia (p < 0,05). No se observaron diferencias estadísticamente significativas entre el plan de seguimiento general y personalizado. Conclusiones: El programa es efectivo en aumentar factores protectores como mantener un peso normal, realizar actividad física regular y consumir al menos 5 porciones de frutas y verduras, consumo de agua, entre otros, lo que permite al participante disminuir los factores de riesgo con independencia del plan de seguimiento(AU)

Introduction: The health situation in Chile with regard to chronic noncommunicable diseases has worsened in recent years. Therefore, programs to change habits that promote protective factors and reduce cardiovascular risk factors are necessary in order to intervene whore the problem arises. Objective: To assess the efficacy of a program with family health advisors through a follow-up study of the measured health indicators. Methods: Analytical, quasiexperimental and longitudinal study carried out in the Chilean cities of Concepción and Temuco. Biometric indicators (BMI, weight, body fat percentage, skeletal muscle percentage, visceral fat level, systolic and diastolic blood pressure, waist circumference and blood glucose) were measured in two follow-up plans (general, one month; and personalized, two months). Results: Upon comparing both plans, it was observed that, in the general follow-up plan, there were differences in weight, body fat percentage, skeletal muscle percentage and BMI (p<0.01), while in the personalized follow-up plan, differences were observed in systolic blood pressure, waist circumference, weight, body fat percentage and BMI (p<0.01), as well as for glycemia (p<0.05). No statistically significant differences were observed between the general and personalized follow-up plans. Conclusions: The program is effective in increasing protective factors such as maintaining a normal weight, performing regular physical activity and consuming at least five servings of fruits and vegetables, water consumption, among others, which allows the participant to decrease risk factors regardless of the follow-up plan(AU)

Six attachment discourses: convergence, divergence and relay.

Attachment concepts are used in diverging ways, which has caused confusion in communication among researchers, among practitioners, and between researchers and practitioners, and hinders their potential for collaboration. In this essay we explore how attachment concepts may vary in meaning across six different domains: popular discourses, developmental science, social psychological science, psychiatric diagnosis, psychotherapy, and child welfare practice. We attempt to typify these forms of attachment discourse by highlighting points of convergence, divergence, and relay between the different domains. Our general conclusions are that diversity in the use of attachment concepts across different domains of application has been largely unrecognised, and that recognition of these differences would reduce confusion, help identify sites where infrastructure needs to be developed to support coordination, and strengthen opportunities for collaboration to mutual benefit. We suggest that academic attachment discourse would benefit from clarification of core terminology, including: "attachment", "internal working model", "trauma", and "dysregulation".

Attachment difficulties and disorders.

Children and young people who are adopted from care, in care, or at risk of going into care are at higher risk of attachment difficulties and disorders. This may increase the likelihood of mental health conditions and poor emotional regulation. GPs play a role in managing this risk in the community in conjunction with a multi-disciplinary team and supporting referrals to secondary care. However, many GPs are unfamiliar with the terminology of attachment difficulties, attachment disorders, secure attachment and insecure attachment. This article aims to explain these terms and provide an update for GPs on the implications of the National Institute for Health and Clinical Excellence guidelines on child attachment, which focuses on looked after children.

Linguistic analysis of the Preschool Five Minute Speech Sample: what the parents of preschool children with early signs of ADHD say and how they say it?

A linguistic analysis was performed on the Preschool Five Minute Speech Sample (PFMSS) of 42 parents. PFMSS is a validated measure for Expressed Emotion (EE) to assess parent-child relationship. Half of these parents (n = 21, clinical group) had preschool children with early symptoms of attention deficit hyperactivity disorder (ADHD), the rest had typically developing children. Early symptoms of ADHD were identified with the Werry-Weiss Peters Rating Scale. The linguistic component of the PFMSS was analysed with keyword and linguistic pattern identification. The results of these two complementary analyses (i.e., EE and linguistic analysis) provided relevant recommendations that may improve the efficacy of psychological treatment for ADHD such as parenting interventions. We discuss the practical implications of these findings.

3 steps to profitable managed care contracts.

An effective managed care contract negotiation strategy should be founded on: Internal analysis that compares performance of your current managed care contracts in terms of volume versus discount rates and volume versus profit. External analysis that compares your current contracts with those of competitors and assesses prevailing market rates, contract language and provisions, and premium trends Payment performance analysis that identifies payment promptness and accuracy and associated penalty dollars for each payer.