Use of behaviour change techniques in lifestyle change interventions for people with intellectual disabilities: A systematic review

Background: People with intellectual disabilities (ID) experience more health problems and have different lifestyle change needs, compared with the general population. Aims: To improve lifestyle change interventions for people with ID, this review examined how behaviour change techniques (BCTs) were applied in interventions aimed at physical activity, nutrition or physical activity and nutrition, and described their quality. Methods and procedures: After a broad search and detailed selection process, 45 studies were included in the review. For coding BCTs, the CALO-RE taxonomy was used. To assess the quality of the interventions, the Physiotherapy Evidence Database (PEDro) scale was used. Extracted data included general study characteristics and intervention characteristics. Outcomes and results: All interventions used BCTs, although theory-driven BCTs were rarely used. The most frequently used BCTs were ‘provide information on consequences of behaviour in general’ and ‘plan social support/social change’. Most studies were of low quality and a theoretical framework was often missing. Conclusion and implications: This review shows that BCTs are frequently applied in lifestyle change interventions. To further improve effectiveness, these lifestyle change interventions could benefit from using a theoretical framework, a detailed intervention description and an appropriate and reliable intervention design which is tailored to people with ID

Systematic review of antimicrobial drug prescribing in hospitals.

Prudent antibiotic prescribing to hospital inpatients has the potential to reduce the incidences of antimicrobial resistance and healthcare-associated infection. We reviewed the literature from January 1980 to November 2003 to identify rigorous evaluations of interventions to improve hospital antibiotic prescribing. We identified 66 studies with interpretable data of which 16 reported 20 microbiological outcomes: Gram negative resistant bacteria (GNRB), 10 studies; Clostridium difficile associated diarrhoea (CDAD), 5 studies; vancomycin resistant enterococci (VRE), 3 studies and methicillin resistant Staphylococcus aureus (MRSA), 2 studies. Four studies provide good evidence that the intervention changed microbial outcomes with low risk of alternative explanations, eight studies provide less convincing evidence and four studies were negative. The strongest and most consistent evidence was for CDAD but we were able to analyse only the immediate impact of interventions because of nonstandardised durations of follow up. The ability to compare results of studies could be substantially improved by standardising methodology and reporting

Definitions, measurement and prevalence of sedentary behaviour in adults with intellectual disabilities – a systematic review

Supporting positive change in lifestyle behaviours is a priority in tackling the health inequalities experienced by adults with intellectual disabilities. In this systematic review, we examine the evidence on the definition, measurement and epidemiology of sedentary behaviour of adults with intellectual disabilities. A systematic literature search of PUBMED, EMBASE, MEDLINE and Google Scholar was performed to identify studies published from 1990 up to October 2015. Nineteen papers met the criteria for inclusion in the systematic review. Many researchers do not distinguish between insufficient physical activity and sedentary behaviour. None of the studies reported the reliability and validity of the methods used to measure sedentary behaviour. Sedentary time, assessed objectively, ranged from 522 to 643 min/day: higher than in adults without intellectual disabilities. This first-ever review of sedentary behaviour and intellectual disabilities found that at present the evidence base is weak. Studies calibrating accelerometer data with criterion measures for sedentary behaviour are needed to determine specific cut-off points to measure sedentary behaviour in adults with intellectual disabilities. Researchers should also examine the reliability and validity of using proxy-report questionnaires to measure sedentary behaviour in this group. A better understanding of sedentary behaviour will inform the design of novel interventions to change lifestyle behaviours of adults with intellectual disabilities

Stakeholder Theory and Marketing: Moving from a Firm-Centric to a Societal Perspective

This essay is inspired by the ideas and research examined in the special section on “Stakeholder Marketing” of the Journal of Public Policy & Marketing in 2010. The authors argue that stakeholder marketing is slowly coalescing with the broader thinking that has occurred in the stakeholder management and ethics literature streams during the past quarter century. However, the predominant view of stakeholders that many marketers advocate is still primarily pragmatic and company centric. The position advanced herein is that stronger forms of stakeholder marketing that reflect more normative, macro/societal, and network-focused orientations are necessary. The authors briefly explain and justify these characteristics in the context of the growing “prosociety” and “proenvironment” perspectives—orientations that are also in keeping with the public policy focus of this journal. Under the “hard form” of stakeholder theory, which the authors endorse, marketing managers must realize that serving stakeholders sometimes requires sacrificing maximum profits to mitigate outcomes that would inflict major damage on other stakeholders, especially society

Gallium(III) chelates of mixed phosphonate-carboxylate triazamacrocyclic ligands relevant to nuclear medicine: structural, stability and in vivo studies

Three triaza macrocyclic ligands, H6NOTP (1,4,7-triazacyclononane-N,N′,N″-trimethylene phosphonic acid), H4NO2AP (1,4,7-triazacyclononane-N-methylenephosphonic acid-N′,N″-dimethylenecarboxylic acid), and H5NOA2P (1,4,7-triazacyclononane-N,N′-bis(methylenephosphonic acid)-N″-methylene carboxylic acid), and their gallium(III) chelates were studied in view of their potential interest as scintigraphic and PET (Positron Emission Tomography) imaging agents. A 1H, 31P and 71Ga multinuclear NMR study gave an insight on the structure, internal dynamics and stability of the chelates in aqueous solution. In particular, the analysis of 71Ga NMR spectra gave information on the symmetry of the Ga3+ coordination sphere and the stability of the chelates towards hydrolysis. The 31P NMR spectra afforded information on the protonation of the non-coordinated oxygen atoms from the pendant phosphonate groups and on the number of species in solution. The 1H NMR spectra allowed the analysis of the structure and the number of species in solution. 31P and 1H NMR titrations combined with potentiometry afforded the measurement of the protonation constants (log KHi) and the microscopic protonation scheme of the triaza macrocyclic ligands. The remarkably high thermodynamic stability constant (log KGaL =34.44 (0.04) and stepwise protonation constants of Ga (NOA2P)2− were determined by potentiometry and 69Ga and 31P NMR titrations. Biodistribution and gamma imaging studies have been performed on Wistar rats using the radiolabeled 67Ga(NO2AP)− and 67Ga (NOA2P)2−chelates, having both demonstrated to have renal excretion. The correlation of the molecular properties of the chelates with their pharmacokinetic properties has been analysed.The authors thank the financial support from the Fundação para a Ciência e Tecnologia (F.C.T., Portugal, projects RREQ/481/QUI/2006 and RECI/QEQ-QFI/0168/2012), the Rede Nacional de RMN (RNRMN), the Hungarian Scientific Research Fund (OTKA grants K-109029 and K-120224), the János Bolyai Research Scholarship (Gy.T.) of the Hungarian Academy of Sciences and the EU COST Action TD1004 “Theragnostics Imaging and Therapy”. The research was also supported by the EU and co-financed by the European Regional Development Fund (FEDER) under the projects CENTRO-07-CT62-FEDER) and GINOP-2.3.2-15-2016-00008.info:eu-repo/semantics/publishedVersio

A systematic review of how emotional self-awareness is defined and measured when comparing autistic and non-autistic groups

We would like to sincerely thank all the authors who shared their data with us. We would also like to thank Ira Lesser, Taylor Graeme, and Arvid Heiberg for kindly sharing their articles for the historical review. Review was conduced as part of CFH's PhD studies. We would like to thank the Northwood Trust, UK for their financial support for this research. Research data available upon request from first author.Peer reviewedPublisher PD

Pre-hospital transdermal glyceryl trinitrate in patients with stroke mimics: data from the RIGHT-2 randomised-controlled ambulance trial

Background: Prehospital stroke trials will inevitably recruit patients with non-stroke conditions, so called stroke mimics. We undertook a pre-specified analysis to determine outcomes in patients with mimics in the second Rapid Intervention with Glyceryl trinitrate in Hypertensive stroke Trial (RIGHT-2). Methods: RIGHT-2 was a prospective, multicentre, paramedic-delivered, ambulance-based, sham-controlled, participant-and outcome-blinded, randomised-controlled trial of transdermal glyceryl trinitrate (GTN) in adults with ultra-acute presumed stroke in the UK. Final diagnosis (intracerebral haemorrhage, ischaemic stroke, transient ischaemic attack, mimic) was determined by the hospital investigator. This pre-specified subgroup analysis assessed the safety and efficacy of transdermal GTN (5 mg daily for 4 days) versus sham patch among stroke mimic patients. The primary outcome was the 7-level modified Rankin Scale (mRS) at 90 days. Results: Among 1149 participants in RIGHT-2, 297 (26%) had a final diagnosis of mimic (GTN 134, sham 163). The mimic group were younger, mean age 67 (SD: 18) vs 75 (SD: 13) years, had a longer interval from symptom onset to randomisation, median 75 [95% CI: 47,126] vs 70 [95% CI:45,108] minutes, less atrial fibrillation and a lower systolic blood pressure and Face-Arm-Speech-Time tool score than the stroke group. The three most common mimic diagnoses were seizure (17%), migraine or primary headache disorder (17%) and functional disorders (14%). At 90 days, the GTN group had a better mRS score as compared to the sham group (adjusted common odds ratio 0.54; 95% confidence intervals 0.34, 0.85; p = 0.008), a difference that persisted at 365 days. There was no difference in the proportion of patients who died in hospital, were discharged to a residential care facility, or suffered a serious adverse event. Conclusions: One-quarter of patients suspected by paramedics to have an ultra-acute stroke were subsequently diagnosed with a non-stroke condition. GTN was associated with unexplained improved functional outcome observed at 90 days and one year, a finding that may represent an undetected baseline imbalance, chance, or real efficacy. GTN was not associated with harm. Trial registration: This trial is registered with International Standard Randomised Controlled Trials Number ISRCTN 26986053