1,842 research outputs found
Effect of exercise referral schemes in primary care on physical activity and improving health outcomes: Systematic review and meta-analysis
This is an open access article - Copyright @ 2011 BMJObjective: To assess the impact of exercise referral schemes on physical activity and health outcomes.
Design: Systematic review and meta-analysis.
Data sources Medline, Embase, PsycINFO, Cochrane Library, ISI Web of Science, SPORTDiscus, and ongoing trial registries up to October 2009. We also checked study references.
Study selection Design: randomised controlled trials or non-randomised
controlled (cluster or individual) studies published in peer review journals.
Population: sedentary individuals with or without medical diagnosis.
Exercise referral schemes defined as: clear referrals by primary care professionals to third party service providers to increase physical activity or exercise, physical activity or exercise programmes tailored to
individuals, and initial assessment and monitoring throughout programmes. Comparators: usual care, no intervention, or alternative exercise referral schemes.
Results Eight randomised controlled trials met the inclusion criteria, comparing exercise referral schemes with usual care (six trials), alternative physical activity intervention (two), and an exercise referral
scheme plus a self determination theory intervention (one). Compared with usual care, follow-up data for exercise referral schemes showed an increased number of participants who achieved 90-150 minutes of
physical activity of at least moderate intensity per week (pooled relative risk 1.16, 95% confidence intervals 1.03 to 1.30) and a reduced level of depression (pooled standardised mean difference −0.82, −1.28 to −0.35). Evidence of a between group difference in physical activity of moderate
or vigorous intensity or in other health outcomes was inconsistent at follow-up. We did not find any difference in outcomes between exercise referral schemes and the other two comparator groups. None of the
included trials separately reported outcomes in individuals with specific medical diagnoses. Substantial heterogeneity in the quality and nature of the exercise referral schemes across studies might have contributed
to the inconsistency in outcome findings.
Conclusions Considerable uncertainty remains as to the effectiveness of exercise referral schemes for increasing physical activity, fitness, or health indicators, or whether they are an efficient use of resources for
sedentary people with or without a medical diagnosis.This project was funded by the National Institute for Health Research Health Technology Assessment (NIHR HTA) programme
(project number 08/72/01) (www.hta.ac.uk/)
Very rapid long-distance sea crossing by a migratory bird
Landbirds undertaking within-continent migrations have the possibility to stop en route, but most long-distance migrants must also undertake large non-stop sea crossings, the length of which can vary greatly. For shorebirds migrating from Iceland to West Africa, the shortest route would involve one of the longest continuous sea crossings while alternative, mostly overland, routes are available. Using geolocators to track the migration of Icelandic whimbrels (Numenius phaeopus), we show that they can complete a round-trip of 11,000 km making two non-stop sea crossings and flying at speeds of up to 24 m s-1; the fastest recorded for shorebirds flying over the ocean. Although wind support could reduce flight energetic costs, whimbrels faced headwinds up to twice their ground speed, indicating that unfavourable and potentially fatal weather conditions are not uncommon. Such apparently high risk migrations might be more common than previously thought, with potential fitness gains outweighing the costs
Higgs friends and counterfeits at hadron colliders
We consider the possibility of "Higgs counterfeits" - scalars that can be
produced with cross sections comparable to the SM Higgs, and which decay with
identical relative observable branching ratios, but which are nonetheless not
responsible for electroweak symmetry breaking. We also consider a related
scenario involving "Higgs friends," fields similarly produced through gg fusion
processes, which would be discovered through diboson channels WW, ZZ, gamma
gamma, or even gamma Z, potentially with larger cross sections times branching
ratios than for the Higgs. The discovery of either a Higgs friend or a Higgs
counterfeit, rather than directly pointing towards the origin of the weak
scale, would indicate the presence of new colored fields necessary for the
sizable production cross section (and possibly new colorless but electroweakly
charged states as well, in the case of the diboson decays of a Higgs friend).
These particles could easily be confused for an ordinary Higgs, perhaps with an
additional generation to explain the different cross section, and we emphasize
the importance of vector boson fusion as a channel to distinguish a Higgs
counterfeit from a true Higgs. Such fields would naturally be expected in
scenarios with "effective Z's," where heavy states charged under the SM produce
effective charges for SM fields under a new gauge force. We discuss the
prospects for discovery of Higgs counterfeits, Higgs friends, and associated
charged fields at the LHC.Comment: 27 pages, 5 figures. References added and typos fixe
Upper atmospheres and ionospheres of planets and satellites
The upper atmospheres of the planets and their satellites are more directly
exposed to sunlight and solar wind particles than the surface or the deeper
atmospheric layers. At the altitudes where the associated energy is deposited,
the atmospheres may become ionized and are referred to as ionospheres. The
details of the photon and particle interactions with the upper atmosphere
depend strongly on whether the object has anintrinsic magnetic field that may
channel the precipitating particles into the atmosphere or drive the
atmospheric gas out to space. Important implications of these interactions
include atmospheric loss over diverse timescales, photochemistry and the
formation of aerosols, which affect the evolution, composition and remote
sensing of the planets (satellites). The upper atmosphere connects the planet
(satellite) bulk composition to the near-planet (-satellite) environment.
Understanding the relevant physics and chemistry provides insight to the past
and future conditions of these objects, which is critical for understanding
their evolution. This chapter introduces the basic concepts of upper
atmospheres and ionospheres in our solar system, and discusses aspects of their
neutral and ion composition, wind dynamics and energy budget. This knowledge is
key to putting in context the observations of upper atmospheres and haze on
exoplanets, and to devise a theory that explains exoplanet demographics.Comment: Invited Revie
Recommended from our members
Purification and functional characterisation of rhiminopeptidase A, a novel aminopeptidase from the venom of Bitis gabonica rhinoceros
This study describes the discovery and characterisation of a novel aminopeptidase A from the venom of B. g. rhinoceros and highlights its potential biological importance. Similar to mammalian aminopeptidases, rhiminopeptidase A might be capable of playing roles in altering the blood pressure and brain function of victims. Furthermore, it could have additional effects on the biological functions of other host proteins by cleaving their N-terminal amino acids. This study points towards the importance of complete analysis of individual components of snake venom in order to develop effective therapies for snake bites
Ecological implications of a flower size/number trade-off in tropical forest trees
Peer reviewedPublisher PD
Effects of insurance status on children's access to specialty care: a systematic review of the literature
<p>Abstract</p> <p>Background</p> <p>The current climate of rising health care costs has led many health insurance programs to limit benefits, which may be problematic for children needing specialty care. Findings from pediatric primary care may not transfer to pediatric specialty care because pediatric specialists are often located in academic medical centers where institutional rules determine accepted insurance. Furthermore, coverage for pediatric specialty care may vary more widely due to systematic differences in inclusion on preferred provider lists, lack of availability in staff model HMOs, and requirements for referral. Our objective was to review the literature on the effects of insurance status on children's access to specialty care.</p> <p>Methods</p> <p>We conducted a systematic review of original research published between January 1, 1992 and July 31, 2006. Searches were performed using Pubmed.</p> <p>Results</p> <p>Of 30 articles identified, the majority use number of specialty visits or referrals to measure access. Uninsured children have poorer access to specialty care than insured children. Children with public coverage have better access to specialty care than uninsured children, but poorer access compared to privately insured children. Findings on the effects of managed care are mixed.</p> <p>Conclusion</p> <p>Insurance coverage is clearly an important factor in children's access to specialty care. However, we cannot determine the structure of insurance that leads to the best use of appropriate, quality care by children. Research about specific characteristics of health plans and effects on health outcomes is needed to determine a structure of insurance coverage that provides optimal access to specialty care for children.</p
Accuracy of dual-source CT coronary angiography: first experience in a high pre-test probability population without heart rate control
The aim of this study was to assess the diagnostic accuracy of dual-source computed tomography (DSCT) for evaluation of coronary artery disease (CAD) in a population with extensive coronary calcifications without heart rate control. Thirty patients (24 male, 6 female, mean age 63.1±11.3 years) with a high pre-test probability of CAD underwent DSCT coronary angiography and invasive coronary angiography (ICA) within 14±9 days. No beta-blockers were administered prior to the scan. Two readers independently assessed image quality of all coronary segments with a diameter ≥1.5 mm using a four-point score (1: excellent to 4: not assessable) and qualitatively assessed significant stenoses as narrowing of the luminal diameter >50%. Causes of false-positive (FP) and false-negative (FN) ratings were assigned to calcifications or motion artifacts. ICA was considered the standard of reference. Mean body mass index was 28.3±3.9 kg/m(2) (range 22.4–36.3 kg/m(2)), mean heart rate during CT was 70.3±14.2 bpm (range 47–102 bpm), and mean Agatston score was 821±904 (range 0–3,110). Image quality was diagnostic (scores 1–3) in 98.6% (414/420) of segments (mean image quality score 1.68±0.75); six segments in three patients were considered not assessable (1.4%). DSCT correctly identified 54 of 56 significant coronary stenoses. Severe calcifications accounted for false ratings in nine segments (eight FP/one FN) and motion artifacts in two segments (one FP/one FN). Overall sensitivity, specificity, positive and negative predictive value for evaluating CAD were 96.4, 97.5, 85.7, and 99.4%, respectively. First experience indicates that DSCT coronary angiography provides high diagnostic accuracy for assessment of CAD in a high pre-test probability population with extensive coronary calcifications and without heart rate control
Psychometric assessment of HIV/STI sexual risk scale among MSM: A Rasch model approach
<p>Abstract</p> <p>Background</p> <p>Little research has assessed the degree of severity and ordering of different types of sexual behaviors for HIV/STI infection in a measurement scale. The purpose of this study was to apply the Rasch model on psychometric assessment of an HIV/STI sexual risk scale among men who have sex with men (MSM).</p> <p>Methods</p> <p>A cross-sectional study using respondent driven sampling was conducted among 351 MSM in Shenzhen, China. The Rasch model was used to examine the psychometric properties of an HIV/STI sexual risk scale including nine types of sexual behaviors.</p> <p>Results</p> <p>The Rasch analysis of the nine items met the unidimensionality and local independence assumption. Although the person reliability was low at 0.35, the item reliability was high at 0.99. The fit statistics provided acceptable infit and outfit values. Item difficulty invariance analysis showed that the item estimates of the risk behavior items were invariant (within error).</p> <p>Conclusions</p> <p>The findings suggest that the Rasch model can be utilized for measuring the level of sexual risk for HIV/STI infection as a single latent construct and for establishing the relative degree of severity of each type of sexual behavior in HIV/STI transmission and acquisition among MSM. The measurement scale provides a useful measurement tool to inform, design and evaluate behavioral interventions for HIV/STI infection among MSM.</p
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