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Wiggins D, Downie A, Engel R, Grace S, Brown BT. Factors that influence the scope of practice of the chiropractic profession in Australia: a thematic analysis. Chiropr Man Therap 2024; 32:18. [PMID: 38802926 PMCID: PMC11131270 DOI: 10.1186/s12998-024-00535-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2023] [Accepted: 03/19/2024] [Indexed: 05/29/2024] Open
Abstract
Scope of practice has been defined as the activities that an individual health care practitioner is allowed to undertake within a specific profession. The chiropractic profession in Australia does not currently have a documented scope of practice. Informed discussions around scope of practice are hampered by a paucity of literature in this area. Acknowledging this void in the literature, we chose to investigate the factors that influence scope of practice of the chiropractic profession. A knowledge of the factors will facilitate discussion on the topic and help the profession to work towards establishing a scope of practice.Aim The aim of this study was to identify the factors that influence scope of practice of chiropractic in Australia from the perspective of 4 stakeholder groups within the profession.Methods This study employed semi-structured, online-interviews. Open-ended questions, guided by a flexible interview protocol, and augmented by supplemental questions, probes and comments, were used to gather data on the research question. Data were analysed using reflexive thematic analysis.Results Six factors that influenced scope of practice of chiropractic were identified in this study: education, evidence (research-derived and practice-based), political influence, community expectations, entrepreneurial business models, and geographical location.Conclusion Knowledge of the factors that influence scope of practice of chiropractic in Australia is important for establishing a scope of practice for the profession. This knowledge is also of value to a range of stakeholders including patients, health care providers (within and outside the profession), professional associations, and policymakers.
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Affiliation(s)
- Desmond Wiggins
- Department of Chiropractic, Macquarie University, Sydney, Australia.
| | - Aron Downie
- Department of Chiropractic, Macquarie University, Sydney, Australia
| | - Roger Engel
- Department of Chiropractic, Macquarie University, Sydney, Australia
| | - Sandra Grace
- Faculty of Health, Southern Cross University, Lismore, Australia
| | - Benjamin T Brown
- Department of Chiropractic, Macquarie University, Sydney, Australia
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Meade MJ, Jensen S, Ju X, Hunter D, Jamieson L. Assessment of the quality and accuracy of information contained within the websites of marketed orthodontic products: a cross-sectional investigation. Angle Orthod 2024; 94:273-279. [PMID: 38639457 PMCID: PMC11050458 DOI: 10.2319/100423-672.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Accepted: 01/01/2024] [Indexed: 04/20/2024] Open
Abstract
OBJECTIVES To assess the quality and accuracy of information contained within the websites of providers of marketed orthodontic products. MATERIALS AND METHODS Twenty-one websites of orthodontic appliance and adjunct (product) providers were identified. The website content was assessed via two validated quality-of-information instruments (DISCERN and the Journal of the American Medical Association [JAMA] benchmarks) and an accuracy-of-information instrument. Website content was qualitatively analyzed for themes and subthemes. RESULTS More than half (n = 11; 52.3%) of the assessed websites contained clinician testimonials. The mean (SD) DISCERN score was 33.14 (5.44). No website recorded the minimum of three JAMA benchmarks required to indicate reliability. The most common content themes related to quality-of-life impact and treatment duration. Just 8% of the statements within the websites were objectively true. The Pearson correlation coefficient indicated that the DISCERN scores were correlated with the accuracy-of-information scores (r = .83; P < .001). CONCLUSIONS The quality and accuracy of information contained within the websites of the providers of marketed orthodontic products was poor. The combined use of DISCERN and the accuracy-of-information instrument may help overcome the shortcomings of each. Clinicians should check the accuracy of information on orthodontic product provider websites before adding links to those websites on their own sites.
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Xie G, Zhang C, Fang Q, Tang X, Zhang Y. Innovation, advertising, personal selling, and sustainability in the industries massively benefited from major public health emergencies: paradoxical evidence from China. Front Public Health 2023; 11:1186026. [PMID: 37869209 PMCID: PMC10585025 DOI: 10.3389/fpubh.2023.1186026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 09/12/2023] [Indexed: 10/24/2023] Open
Abstract
Background While major public health emergencies have severe socio-economic impacts, they may also present many opportunities for certain industries. For these industries that have benefited significantly (e.g., China' s healthcare industry), the traditional emphasis on improving business performance through increased investment in innovation, marketing and sustainability may face contextual applicability challenges. Methods We used the data of healthcare industry in China during Covid-19 and the methods of hierarchical regression, moderating effect test to analyze the impact of innovation, advertising, personal selling, and sustainability on healthcare firms' profitability. Three kinds of robust test including increasing the measurement range of variables, changing the data source and parameter estimation method, and Quantile regression are used. Results This paper finds that innovation, advertising, and environmental sustainability have significant negative impacts on profitability, while personal selling, social sustainability, and governance sustainability have significant positive impacts on profitability in the industries massively benefited from major public health emergencies. Besides, social sustainability can significantly moderate the relationship between innovation and profitability. Conclusion On one hand, for companies in industries that have benefited greatly from major public health emergencies, a shift in resource allocation from innovation, advertising, and environmental sustainability to personal selling, social sustainability, and governance sustainability may be more conducive to improving their profitability. On the other hand, for public health regulatory authorities, it is necessary to strengthen the supervision of sales representatives of health care enterprises, hospitals, public health organizations, etc., and appropriately subsidize the innovation of enterprises to enhance their innovation motivation.
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Affiliation(s)
- Guangying Xie
- School of Economics and Management, China University of Mining and Technology, Xuzhou, China
| | - Cancan Zhang
- School of Business, Dongguan City University, Dongguan, China
| | - Qianqian Fang
- School of Finance, Zhengzhou College of Finance and Economics, Zhengzhou, China
| | - Xiaole Tang
- School of Finance, Zhengzhou College of Finance and Economics, Zhengzhou, China
| | - Yani Zhang
- Chaobo Medical Materials Farming Cooperatives of Yangcheng, Jincheng, China
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Braun P, Schwientek AK, Angerer P, Guthardt L, Icks A, Loerbroks A, Apolinário-Hagen J. Investigating information needs and preferences regarding digital mental health services among medical and psychology students in Germany: A qualitative study. Digit Health 2023; 9:20552076231173568. [PMID: 37256006 PMCID: PMC10226173 DOI: 10.1177/20552076231173568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 04/17/2023] [Indexed: 06/01/2023] Open
Abstract
Background Since 2020, physicians and psychotherapists in Germany can prescribe digital mental health services (dMHSs). However, even future healthcare professionals (HCPs), such as medical and psychology students, remain reluctant to use dMHSs, although they are a risk group for mental health issues themselves. Reasons include scepticism and lacking awareness of dMHSs, which can be addressed by acceptance-facilitating interventions (AFIs) such as information strategies. To date, though, little is known about their information needs. Methods Semi-structured interviews with n = 21 students were conducted between August and September 2021. Students of legal age studying psychology or medicine at a German university could participate. Interview recordings were transcribed verbatim and content-analyzed according to Mayring, using deductive and inductive coding. Results Most students reported having little experience with dMHSs. Digital health has barely been raised in their study, even though it was perceived as crucial for personal needs as well as in preparation for their work as HCPs. Students favoured receiving information on and recommendations for dMHSs from their university via, e.g. social media or seminars. Among others, information about data safety, scientific evidence base and application scope were preferred. Additionally, information on costs as well as user reviews seemed to be essential components of information strategies because students were concerned that high costs or low usability would hinder uptake. Conclusions The results give first insights on how future HCPs would like to be informed on dMHSs. Future research should focus on systematic variations of AFIs' components mimicking real-world decision scenarios to increase the adoption of dMHSs.
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Affiliation(s)
- Pia Braun
- Institute of Occupational, Social and
Environmental Medicine, Centre for Health and Society, Medical Faculty, Heinrich Heine University
Düsseldorf, Dusseldorf, Germany
| | - Ann-Kathrin Schwientek
- Institute of Occupational, Social and
Environmental Medicine, Centre for Health and Society, Medical Faculty, Heinrich Heine University
Düsseldorf, Dusseldorf, Germany
- Department of Psychiatry and
Psychotherapy, University Hospital rechts der Isar, School of Medicine, Technical
University of Munich, Munchen, Germany
| | - Peter Angerer
- Institute of Occupational, Social and
Environmental Medicine, Centre for Health and Society, Medical Faculty, Heinrich Heine University
Düsseldorf, Dusseldorf, Germany
| | - Lisa Guthardt
- Institute of Occupational, Social and
Environmental Medicine, Centre for Health and Society, Medical Faculty, Heinrich Heine University
Düsseldorf, Dusseldorf, Germany
| | - Andrea Icks
- Institute for Health Services Research
and Health Economics, Centre for Health and Society, Medical Faculty, Heinrich Heine University
Düsseldorf, Dusseldorf, Germany
| | - Adrian Loerbroks
- Institute of Occupational, Social and
Environmental Medicine, Centre for Health and Society, Medical Faculty, Heinrich Heine University
Düsseldorf, Dusseldorf, Germany
| | - Jennifer Apolinário-Hagen
- Institute of Occupational, Social and
Environmental Medicine, Centre for Health and Society, Medical Faculty, Heinrich Heine University
Düsseldorf, Dusseldorf, Germany
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Donnell CC, Iafrate LF, Worthington SW. The 'five star' fallacy: an analysis of online reviews and testimonials of dental practices in Northern England. Br Dent J 2022:10.1038/s41415-022-4977-0. [PMID: 36138099 DOI: 10.1038/s41415-022-4977-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Accepted: 05/26/2022] [Indexed: 11/08/2022]
Abstract
Aims and objectives To develop a greater understanding of how dental practices in the UK utilise and promote patient reviews and testimonials. To compare and contrast the star ratings, levels of engagement and levels of identifiability by comparing those placed by patients on social media, review websites and search engines, to those placed on providers' own websites. To provide recommendations for future advertising guidance.Materials and methods All practices providing dental services in North East England and Cumbria were identified from the Care Quality Commission database. A web-based Google search for the respective dental practice websites, NHS listings, Facebook pages and Google results page listings was performed. The presence or absence of patient testimonials and reviews was recorded, alongside the total number of testimonials/reviews and the number of non-identifiable testimonials/reviews. Data were analysed using Microsoft Excel and SPSS Statistics.Results Of the 401 practice websites, 19.7% (n = 79) contained at least one graded review, while 40.9% (n = 158) of the 386 NHS listings; 87.2% (n = 272) of the 343 Facebook pages; and 94.4% (n = 442) of the 468 Google listings also contained at least one graded review. All of the 1,798 testimonials observed on practice websites were positive in their sentiment. Further, 22 practices utilised video testimonials. Each of the online review locations showed overall mean scores above 4.5 out of 5 stars.Conclusions Dental practice websites, the NHS website, Facebook and Google utilise testimonials and reviews in distinct and diverse ways. Unlike other jurisdictions around the world, the UK does not have guidance in this area. Electronic word of mouth is often replete with bias, and as such, patients need to be encouraged to seek out multiple sources before decision-making. Facebook and Google may be perceived to be more 'trustworthy' sources of information as they appear less curated and less susceptible to manipulation than practice websites, which the public may feel gives greater credence to the information they provide. In order to achieve the highest standards of integrity and honesty, advertising guidance surrounding reviews and testimonials would benefit from future revision.
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Affiliation(s)
- Christopher C Donnell
- Specialty Registrar in Paediatric Dentistry, Charles Clifford Dental Hospital, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK. Academic Unit of Oral Health, Dentistry and Society, School of Clinical Dentistry, University of Sheffield, Sheffield, UK.
| | - Lorenzo F Iafrate
- Dental Core Trainee 3, Dental Public Health, NHS England, Newcastle upon Tyne, UK
| | - Stuart W Worthington
- Speciality Registrar, Dental Public Health, Public Health England, Newcastle upon Tyne, UK
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Feng B, Park JS, Lee J, Tennant M, Kruger E. Perceptions of service quality in Victorian public dental clinics using Google patient reviews. AUST HEALTH REV 2022; 46:485-495. [PMID: 35732307 DOI: 10.1071/ah21393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 05/15/2022] [Indexed: 11/23/2022]
Abstract
ObjectivesUsing Google online reviews, this study investigated why patients were satisfied or dissatisfied with their public dental clinic in Victoria, Australia.MethodsThis mixed methods study gathered Google reviews published by users pre-March, 2021. The reviews were coded and subthemes and major themes were identified. The most common reasons why patients gave reviews were tabulated and stratified according to star rating, remoteness and accessibility index classification, and socio-economic status.ResultsOf the 522 reviews included in this study, in 317 (60.7%) satisfaction was expressed. Compliments and complaints were documented. A total of 53 subthemes were identified. Major themes included Treatment, Staff, Communication and Professionalism, Patient Factors and Non-Clinical Reasons. From the reviews, more patients were satisfied with general unspecified treatment (n = 195; 14.7%) and dissatisfied with reception staff (n = 64; 4.8%). More reviews were generated by patients who visited clinics in major cities and lower socio-economic areas.ConclusionThis study found that most patients expressed satisfaction and identified reasons why patients were satisfied or dissatisfied. Consumer feedback, including compliments and complaints, is an integral aspect of monitoring and improving health service quality. It is important to continue seeking feedback and improve accordingly.
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Affiliation(s)
- Boxi Feng
- International Research Collaborative - Oral Health and Equity, The University of Western Australia, Crawley, WA, Australia
| | - Joon Soo Park
- International Research Collaborative - Oral Health and Equity, The University of Western Australia, Crawley, WA, Australia; and UWA Dental School, The University of Western Australia, Nedlands, WA, Australia
| | - Joshua Lee
- International Research Collaborative - Oral Health and Equity, The University of Western Australia, Crawley, WA, Australia
| | - Marc Tennant
- International Research Collaborative - Oral Health and Equity, The University of Western Australia, Crawley, WA, Australia
| | - Estie Kruger
- International Research Collaborative - Oral Health and Equity, The University of Western Australia, Crawley, WA, Australia
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Abstract
The chiropractic profession is 125 years old and has evolved a culture beset with internal conflict. The internal ructions have been particularly noticeable during the last 20 years. The recent resignation of the entire World Federation of Chiropractic Research Committee has again focussed the conflicting views and goals of the “wellness” and “evidence” factions within the profession. These polarising viewpoints are worsening to the degree that there are calls for the profession to break into two separate entities. Key to the recognition of the differences within the profession is the recognition of title for particular sub populations of patients presenting to chiropractors. For many of the sub populations such as sport or paediatrics there has grown appropriate post professional specialist educational training sometimes leading to a protected title. However, this is not occurring in that group of practitioners that choose to focus on wellness care. A recommendation is made that wellness chiropractic be viewed as a post professional specialty program within chiropractic, as it is in medicine and elsewhere, and that recognition follow after appropriate post professional educational programs have been completed, as is customary in the other special interest groups. In order to do so, consensus will be required from all stakeholders within the profession on the level, scope and depth of such programs. Furthermore, it is possible that different jurisdictions around the world may require different post graduate educational levels based on local competitive, legal and professional circumstances. In such cases, transitioning to the higher level over a period of time may be undertaken. Recognition of the wellness specialty by the profession would allow for vertical integration with other healthcare providers as well as help bridge a gap between the entrepreneur and academic groups that would be responsible for creating these programs at tertiary education institutions. Finally, should these programs acquire evidence to underpin them, a process that would be taught within the programs, it is likely that recognition of an extended scope of practice would occur increasing the appeal of chiropractic to the public.
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Affiliation(s)
- Henry Pollard
- Department of Chiropractic, School of Medical and Applied Sciences, CQUniversity, Brisbane, Australia.
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Apolinário-Hagen J, Fritsche L, Wopperer J, Wals F, Harrer M, Lehr D, Ebert DD, Salewski C. Investigating the Persuasive Effects of Testimonials on the Acceptance of Digital Stress Management Trainings Among University Students and Underlying Mechanisms: A Randomized Controlled Trial. Front Psychol 2021; 12:738950. [PMID: 34721212 PMCID: PMC8549694 DOI: 10.3389/fpsyg.2021.738950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Accepted: 08/31/2021] [Indexed: 11/13/2022] Open
Abstract
Objective: This experiment aims to investigate the influence of narrative information varying in the degree of perceived similarity and source credibility in supplemented testimonials on the acceptance of digital mental health services (digi-MHSs). Methods: In fall 2020, n=231 university students were randomly assigned to an active control group (aCG, n=55, “information only”) or one of three intervention groups (IGs) receiving information plus different testimonials being presented either by nonacademic staff (IG1, n=60), university students (IG2, n=58) or experts (IG3, n=58). We assessed mediation effects of similarity and credibility on acceptance in terms of attitudes and usage intentions. Results: Exposure to testimonials was associated with higher usage intentions (d=0.50) and more positive attitudes toward digi-MHSs (d=0.32) compared to mere information (aCG). Regarding source-related effects, one-way ANOVA showed group differences in intentions (ηp2=0.13) that were significantly higher after exposure to testimonials targeted at students than in the other groups after adjusting for baseline intentions (ηp2=0.24). Concerning underlying mechanisms, there were full mediation effects of similarity (IG1 versus IG2) on attitudes [95%CI (0.030, 0.441)] and intentions to use digi-MHSs [95%CI (0.100, 0.528)] and of credibility on attitudes [IG2 versus IG3; 95%CI (−0.217, −0.004)], all favoring students’ testimonials. Conclusion: Overall, this study indicates that the acceptance of digi-MHSs can be substantially increased by providing a simple, context-sensitive information intervention, including testimonials by university students. Since we identified mediating effects of credibility on cognitive attitudes and similarity on affect-driven intentions, a future trial could vary these features using narrative versus statistic information on digi-MHSs.
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Affiliation(s)
- Jennifer Apolinário-Hagen
- Institute of Occupational, Social and Environmental Medicine, Centre of Health and Society, Faculty of Medicine, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Lara Fritsche
- Department of Health Psychology, Faculty of Psychology, University of Hagen, Hagen, Germany
| | | | - Frank Wals
- Faculty of Psychology, University of Hagen, Hagen, Germany
| | - Mathias Harrer
- Department of Clinical Psychology and Psychotherapy, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany
| | - Dirk Lehr
- Department of Health Psychology and Applied Biological Psychology, Institute of Psychology, Leuphana University Lueneburg, Lueneburg, Germany
| | - David D Ebert
- Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany
| | - Christel Salewski
- Department of Health Psychology, Faculty of Psychology, University of Hagen, Hagen, Germany
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