A brief report on the development of a theoretically-grounded intervention to promote patient autonomy and self-management of physiotherapy patients: Face validity and feasibility of implementation

Background Clinical practice guidelines for the treatment of low back pain suggest the inclusion of a biopsychosocial approach in which patient self-management is prioritized. While many physiotherapists recognise the importance of evidence-based practice, there is an evidence practice gap that may in part be due to the fact that promoting self-management necessitates change in clinical behaviours. Evidence suggests that a patient’s motivation and maintenance of self-management behaviours can be positively influenced by the clinician’s use of an autonomy supportive communication style. Therefore, the aim of this study was to develop and pilot-test the feasibility of a theoretically derived implementation intervention to support physiotherapists in using an evidence-based autonomy supportive communication style in practice for promoting patient self-management in clinical practice. Methods A systematic process was used to develop the intervention and pilot-test its feasibility in primary care physiotherapy. The development steps included focus groups to identify barriers and enablers for implementation, the theoretical domains framework to classify determinants of change, a behaviour change technique taxonomy to select appropriate intervention components, and forming a testable theoretical model. Face validity and acceptability of the intervention was pilot-tested with two physiotherapists and monitoring their communication with patients over a three-month timeframe. Results Using the process described above, eight barriers and enablers for implementation were identified. To address these barriers and enablers, a number of intervention components were selected ranging from behaviour change techniques such as, goal-setting, self-monitoring and feedback to appropriate modes of intervention delivery (i.e. continued education meetings and audit and feedback focused coaching). Initial pilot-testing revealed the acceptability of the intervention to recipients and highlighted key areas for refinement prior to scaling up for a definitive trial. Conclusion The development process utilised in this study ensured the intervention was theory-informed and evidence-based, with recipients signalling its relevance and benefit to their clinical practice. Future research should consider additional intervention strategies to address barriers of social support and those beyond the clinician level

Identity, legitimacy and cooperation with police: comparing general-population and street-population samples from London

Social identity is a core aspect of procedural justice theory, which predicts that fair treatment at the hands of power holders such as police expresses, communicates, and generates feelings of inclusion, status, and belonging within salient social categories. In turn, a sense of shared group membership with power holders, with police officers as powerful symbolic representatives of “law-abiding society,” engenders trust, legitimacy, and cooperation. Yet, this aspect of the theory is rarely explicitly considered in empirical research. Moreover, the theory rests on the underexamined assumption that the police represent one fixed and stable superordinate group, including the often-marginalized people with whom they interact, and that it is only superordinate identification that is important to legitimacy and cooperation. In this article, we present results from two U.K.-based studies that explore the identity dynamics of procedural justice theory. We reason that the police not only represent the “law-abiding, national citizen” superordinate group but also are a symbol of order/conflict and a range of connected social categories that can generate relational identification. First, we used a general-population sample and found that relational identification with police and identification as a law-abiding citizen mediated some of the association between procedural justice and legitimacy and were both stronger predictors of cooperation than legitimacy. Second, a sample of people living on the streets of London was used to explore these same relationships among a highly marginalized group for whom the police might represent a salient outgroup. We found that relational and superordinate identification were both strong positive predictors of cooperation, whereas legitimacy was not. These results have important implications for our understanding of both police legitimacy and public cooperation, as well as the extent to which police activity can serve to include—or exclude—members of the public

(p,q)-Deformations and (p,q)-Vector Coherent States of the Jaynes-Cummings Model in the Rotating Wave Approximation

Classes of (p,q)-deformations of the Jaynes-Cummings model in the rotating wave approximation are considered. Diagonalization of the Hamiltonian is performed exactly, leading to useful spectral decompositions of a series of relevant operators. The latter include ladder operators acting between adjacent energy eigenstates within two separate infinite discrete towers, except for a singleton state. These ladder operators allow for the construction of (p,q)-deformed vector coherent states. Using (p,q)-arithmetics, explicit and exact solutions to the associated moment problem are displayed, providing new classes of coherent states for such models. Finally, in the limit of decoupled spin sectors, our analysis translates into (p,q)-deformations of the supersymmetric harmonic oscillator, such that the two supersymmetric sectors get intertwined through the action of the ladder operators as well as in the associated coherent states.Comment: 1+25 pages, no figure

Learning about knowledge: A complex network approach

This article describes an approach to modeling knowledge acquisition in terms of walks along complex networks. Each subset of knowledge is represented as a node, and relations between such knowledge are expressed as edges. Two types of edges are considered, corresponding to free and conditional transitions. The latter case implies that a node can only be reached after visiting previously a set of nodes (the required conditions). The process of knowledge acquisition can then be simulated by considering the number of nodes visited as a single agent moves along the network, starting from its lowest layer. It is shown that hierarchical networks, i.e. networks composed of successive interconnected layers, arise naturally as a consequence of compositions of the prerequisite relationships between the nodes. In order to avoid deadlocks, i.e. unreachable nodes, the subnetwork in each layer is assumed to be a connected component. Several configurations of such hierarchical knowledge networks are simulated and the performance of the moving agent quantified in terms of the percentage of visited nodes after each movement. The Barab\'asi-Albert and random models are considered for the layer and interconnecting subnetworks. Although all subnetworks in each realization have the same number of nodes, several interconnectivities, defined by the average node degree of the interconnection networks, have been considered. Two visiting strategies are investigated: random choice among the existing edges and preferential choice to so far untracked edges. A series of interesting results are obtained, including the identification of a series of plateaux of knowledge stagnation in the case of the preferential movements strategy in presence of conditional edges.Comment: 18 pages, 19 figure

An exploratory study of the relative effects of various protective factors on depressive symptoms among older people

© Copyright © 2020 Worrall, Jongenelis, McEvoy, Jackson, Newton and Pettigrew. Objective: The present study investigated the relative importance of various factors found to be negatively associated with depressive symptoms in older adults and assessed the potential moderating effect of sociodemographic characteristics for each factor. Method: Depressive symptoms were measured with the Center of Epidemiological Studies Depression Scale. Psychological, social, and physical health measures relating to the following factors were also administered: personal growth, purpose in life, self-esteem, self-efficacy, social support, self-rated health, life satisfaction, and physical activity. Multivariate linear regression analysis was used to investigate the most important factors associated with depressive symptoms, and moderation analyses were employed to identify any moderating effects of sociodemographic factors. Results: Life satisfaction, self-esteem, and purpose in life were found to be negatively associated with depressive symptoms. Only one moderating effect was observed—the negative relationship between life satisfaction and depressive symptoms was significantly stronger among the younger respondents. Conclusion: These findings suggest that strategies for the prevention or amelioration of depressive symptoms across subgroups of the senior population could be optimized by focusing on enhancing life satisfaction, self-esteem, and purpose in life

Testing campaign slogans designed to motivate older people to be more physically active

Objectives and importance of study: Being physically active is critical for healthy ageing, yet many older people do not meet physical activity guidelines. The aim of this study was to test the relative effectiveness of five previously identified campaign slogans designed to encourage older people to be more physically active: ‘Be active 30–60 minutes a day to stay fit and well’; ‘Move more, live longer’; ‘Stay fit to stay functional’; ‘This is your time – enjoy being strong and active’; and ‘Use it or lose it’. Study type: Online experiment Methods: A total of 1200 Australians aged 50 years and older (50% female, mean age 65 years) were recruited to complete an online survey, with respondents randomised to answer a series of questions on a video featuring one of the five slogan conditions. One-way ANOVAs with Tukey’s post-hoc tests were used to identify differences in outcomes between slogans. Results: Overall, the slogans were assessed favourably, suggesting older adults may be receptive to messages about increasing their physical activity. ‘Use it or lose it ‘performed best across the outcome measures of internal and external motivation, perceived effectiveness, liking, believability, and personal relevance. Conclusion: Efforts to encourage physical activity among older Australians could use the slogan ‘Use it or lose it’ as an evidence-based tagline. © 2023 Pettigrew et al

Psychological distress and quality of life in asymptomatic adults following provision of imaging results for prevention of cardiovascular disease events: A scoping review

Aims Psychological distress and changes in health-related quality of life (HRQoL) may occur after screening for disease. Reporting outcomes related to potential benefits and harms of screening is a key recommendation in the guidelines for reporting high-quality trials or interventions. However, no reviews have directly investigated outcomes related to psychological distress and/or changes in HRQoL following imaging assessment of cardiovascular risk and communication of cardiovascular findings to asymptomatic adults. A scoping review was conducted to map research on psychological distress and/or HRQoL following screening. Methods and results Six electronic databases (MEDLINE, PsychINFO, Social Work Abstracts, Psychology and Behavioural Sciences Collection, CINAHL, and EMBASE) were searched for articles that assessed psychological distress and/or HRQoL following screening. Two investigators independently screened titles and abstracts for all records retrieved using predefined criteria. Studies were conducted among active smokers, military personnel, athletes, post-menopausal women, and high-risk individuals. Seven constructs related to psychological distress and HRQoL appeared across 11 articles (randomized controlled trials, n = 4 and non-randomized studies, n = 7). Worry, depression, perceived stress, anxiety, and quality of life were most prominent. Multiple-item measures of psychological distress (e.g. Taylor Anxiety Score and Beck Depression Inventory) were used in 5/9 (56%) studies. Key findings on psychological distress and/or changes in HRQoL following screening were mixed. Conclusions Findings support the need for multiple-item measures with better psychometric properties to examine the psychological responses to screening results in future studies. Strategies to support individuals during and following vascular screening to maximise potential benefits of screening and minimize harms are discussed

Psychological distress and quality of life in asymptomatic adults following provision of imaging results for prevention of cardiovascular disease events: a scoping review

Aims: Psychological distress and changes in health-related quality of life (HRQoL) may occur after screening for disease. Reporting outcomes related to potential benefits and harms of screening is a key recommendation in the guidelines for reporting high-quality trials or interventions. However, no reviews have directly investigated outcomes related to psychological distress and/or changes in HRQoL following imaging assessment of cardiovascular risk and communication of cardiovascular findings to asymptomatic adults. A scoping review was conducted to map research on psychological distress and/or HRQoL following screening. Methods and results: Six electronic databases (MEDLINE, PsychINFO, Social Work Abstracts, Psychology and Behavioural Sciences Collection, CINAHL, and EMBASE) were searched for articles that assessed psychological distress and/or HRQoL following screening. Two investigators independently screened titles and abstracts for all records retrieved using predefined criteria. Studies were conducted among active smokers, military personnel, athletes, post-menopausal women, and high-risk individuals. Seven constructs related to psychological distress and HRQoL appeared across 11 articles (randomized controlled trials, n = 4 and non-randomized studies, n = 7). Worry, depression, perceived stress, anxiety, and quality of life were most prominent. Multiple-item measures of psychological distress (e.g. Taylor Anxiety Score and Beck Depression Inventory) were used in 5/9 (56%) studies. Key findings on psychological distress and/or changes in HRQoL following screening were mixed. Conclusions: Findings support the need for multiple-item measures with better psychometric properties to examine the psychological responses to screening results in future studies. Strategies to support individuals during and following vascular screening to maximise potential benefits of screening and minimize harms are discussed

Assessing cognitive dysfunction in Parkinson's disease: An online tool to detect visuo-perceptual deficits.

BackgroundPeople with Parkinson's disease (PD) who develop visuo-perceptual deficits are at higher risk of dementia, but we lack tests that detect subtle visuo-perceptual deficits and can be performed by untrained personnel. Hallucinations are associated with cognitive impairment and typically involve perception of complex objects. Changes in object perception may therefore be a sensitive marker of visuo-perceptual deficits in PD.ObjectiveWe developed an online platform to test visuo-perceptual function. We hypothesised that (1) visuo-perceptual deficits in PD could be detected using online tests, (2) object perception would be preferentially affected, and (3) these deficits would be caused by changes in perception rather than response bias.MethodsWe assessed 91 people with PD and 275 controls. Performance was compared using classical frequentist statistics. We then fitted a hierarchical Bayesian signal detection theory model to a subset of tasks.ResultsPeople with PD were worse than controls at object recognition, showing no deficits in other visuo-perceptual tests. Specifically, they were worse at identifying skewed images (P < .0001); at detecting hidden objects (P = .0039); at identifying objects in peripheral vision (P < .0001); and at detecting biological motion (P = .0065). In contrast, people with PD were not worse at mental rotation or subjective size perception. Using signal detection modelling, we found this effect was driven by change in perceptual sensitivity rather than response bias.ConclusionsOnline tests can detect visuo-perceptual deficits in people with PD, with object recognition particularly affected. Ultimately, visuo-perceptual tests may be developed to identify at-risk patients for clinical trials to slow PD dementia. © 2018 The Authors. Movement Disorders published by Wiley Periodicals, Inc. on behalf of International Parkinson and Movement Disorder Society

Convergence rate of dimension reduction in Bose-Einstein condensates

In this paper, we study dimension reduction of the three-dimensional (3D) Gross-Pitaevskii equation (GPE) modelling Bose-Einstein condensation under different limiting interaction and trapping frequencies parameter regimes. Convergence rates for the dimension reduction of 3D ground state and dynamics of the GPE in the case of disk-shaped condensation and cigar-shaped condensation are reported based on our asymptotic and numerical results. In addition, the parameter regimes in which the 3D GPE cannot be reduced to lower dimensions are identified.Comment: 27pages; 9 figure