Medical Research: Emerging Concepts and Applications Vol. 6

Health Behaviours and Their Psychological Determinants: Concepts, Models and Implications for Health Promotion

Priya Magesh — 2026-10-28

Health-related actions depend not only on what people know or intend but also on their capabilities, learned routines, social relationships and opportunities to act. Explanatory models have proliferated, yet predictive success is often conflated with evidence that modifying a determinant will change behaviour. This critical narrative review evaluates the conceptual assumptions, evidential strengths and practical implications of prominent psychological and integrative frameworks for health promotion. Targeted scholarly retrieval and citation examination informed a thematic synthesis of foundational models, prospective studies, experimental evidence and contemporary systematic and umbrella reviews. The analysis compares health-belief and planned-behaviour approaches, social cognitive and self-determination theories, action-regulation and stage frameworks, and capability–opportunity–motivation accounts. Across domains, intentions and perceived efficacy are informative correlates of health action but are not reliable surrogates for enactment. Evidence concerning planning, monitoring and feedback supports carefully specified interventions, while habit and environmental opportunity help explain persistence, failure and the unequal distribution of benefits. Applications to physical activity, diet, tobacco and alcohol use, vaccination, screening and medication adherence illustrate why a successful mechanism cannot automatically be transferred between behavioural contexts. A theory label does not in itself establish greater effectiveness, and reported mechanisms are often confounded by bundled components, self-reported outcomes, selective follow-up and inadequate assessment of service access. Practical health promotion should begin with a precise behavioural target, distinguish subjective from material barriers and choose intervention functions whose causal predictions can be evaluated against actual behaviour and implementation outcomes. Future progress requires longitudinal mechanism tests, credible comparators, measures of maintenance and equitable reach, and more rigorous examination of context-dependent effects. Psychological insight is most useful when joined to the real conditions that make health-supporting action feasible.

Platelet-Rich Fibrin in Tympanic Membrane Repair: A Critical Appraisal of Biological Rationale, Clinical Evidence and Methodological Constraints

Monika Patel — 2026-10-28

Tympanic membrane perforation remains one of the most common structural consequences of chronic middle-ear disease, and surgical closure continues to fail in a clinically meaningful minority of cases despite refinements in graft material and surgical access. Platelet-rich fibrin, an autologous second-generation platelet concentrate produced without anticoagulant or bovine thrombin, has been promoted over the past two decades as a biologically active adjunct capable of improving graft uptake, accelerating epithelial closure and reducing postoperative infection. This review critically evaluates the coherence between the biological rationale for platelet-rich fibrin and the clinical evidence assembled in otology, and examines why pooled estimates of benefit and the findings of the most recent controlled trials have diverged. Literature was identified through structured searching of scholarly databases and indexes covering the period from the introduction of the technique to mid-2026, supplemented by backward and forward citation tracking, and appraised against design-specific criteria rather than a formal scoring instrument. Three findings emerge. The laboratory rationale is internally consistent and reproducible, resting on sustained growth-factor release from an autologous fibrin scaffold, but it has been transferred to the middle ear largely by analogy with oral and periodontal applications rather than through tympanic-specific mechanistic work. Early clinical studies reported large anatomical advantages, whereas trials published after 2023, several with larger samples, tighter blinding and active rather than inert comparators, have reported no significant difference in graft uptake. Anatomical and audiological outcomes are consistently dissociated, with no reproducible hearing advantage attributable to the concentrate itself. Preparation protocols, application formats and comparator choices differ so widely between studies that the intervention evaluated is not a single entity, and pooled odds ratios derived from such material overstate the precision of what is known. The evidence supports platelet-rich fibrin as a safe, inexpensive and logistically convenient autologous material with a plausible adjunctive role in selected perforations, but it does not yet support claims of superiority over established graft techniques. Protocol standardisation, transparent reporting and adequately powered trials with active comparators are prerequisites for any stronger conclusion.

Lymphocyte-to-Monocyte Ratio and Interleukin-6 as Blood-Based Markers for Identifying Intrahepatic Cholangiocarcinoma

Teerachat Saeheng — 2026-10-28

Intrahepatic cholangiocarcinoma (iCCA) is an aggressive biliary tract malignancy for which practical blood-based markers may facilitate the identification of patients requiring further diagnostic evaluation. This study evaluated peripheral blood inflammatory indices and circulating cytokines as potential markers of advanced iCCA. Baseline laboratory data were analysed from 40 healthy volunteers and 45 patients with advanced iCCA. Neutrophil-to-lymphocyte ratio, lymphocyte-to-monocyte ratio (LMR), platelet-to-lymphocyte ratio and systemic immune-inflammation index were calculated from complete blood counts, while serum cytokines were measured by flow cytometry. Diagnostic performance was assessed using receiver operating characteristic analysis and logistic regression. Patients with iCCA had significantly lower LMR and higher interleukin-6 (IL6) concentrations than healthy volunteers. LMR showed an area under the receiver operating characteristic curve of 0.91, with a sensitivity of 0.91 and a specificity of 0.85 at a cut-off below 7.2. IL6 yielded an area under the curve of 0.81, with a sensitivity of 0.70 and a specificity of 0.91 at a cut-off above 11.635 pg/mL. Logistic regression identified LMR and IL6 as important discriminating variables, and probability-based categories were derived for both markers. These findings indicate that LMR and IL6 may assist in distinguishing patients with advanced iCCA from healthy individuals. Because LMR can be calculated from a routine complete blood count, it may offer a practical candidate marker for further investigation. Larger, age-matched studies involving relevant hepatobiliary disease controls and external validation are required before clinical screening use can be established.