1,611 research outputs found
Evaluation of a gender-sensitive physical activity programme for inactive men in Ireland: Protocol paper for a pragmatic controlled trial
The excess burden of ill-health, mortality and premature death experienced by many men, and poorer men in particular, across the developed world has prompted calls for the development of gender sensitised health related services for men. An emergent body of evidence indicates that successful public health work with men can be accomplished when it utilises elements with which men are familiar and secure. In particular, physical activity (PA) is proven here to be a useful ‘hook’ to engage men. ‘Men on the Move’ (MoM) is a community-based PA programme designed to engage inactive men to improve their overall health and well-being. The MoM programme was delivered by practitioner partnerships in diverse communities and among diverse groups of men under ‘real world’ conditions to assess both its efficacy and replicability with a view to scaling-up the programme nationally for population wide impact. Establishing appropriate protocols is critical when conducting research that translates into practice, is replicable in practice and can be disseminated at a population level. The purpose of this paper is to detail the protocols used in the design, implementation and evaluation of the MoM programme. Specifically, the process of engaging men in a community based PA intervention and sustaining that engagement over the 12 weeks and the protocols used to evaluate the impact of participation in MoM on biopsychosocial health up to 52 weeks will be outlined. If the intervention proves successful, gender-sensitive community based PA interventions for men could be a promising avenue to address their health needs. These findings may be of support to both practitioners endeavouring to engage men and others engaged in translational research to ensure their research translates to meaningful action in practice
The impact of a gender-specific physical activity intervention on the fitness and fatness profile of men in Ireland
Background: Amid increasing concerns about rising obesity rates and unhealthy lifestyle behaviours, physical activity (PA) is seen as a prophylactic to many chronic conditions affecting men. Men respond best to community-based PA programmes, using gender-specific promotional and delivery strategies. ‘Men on the Move’ (MOM) was developed on this basis and targeted inactive adult men in Ireland.
Methods: Sedentary men (n=927; age=50.7±10.9yr; Weight=92.7±16.0kg; METS=6.06±2.13) were recruited across 8 counties; 4 ‘intervention group’ (IG; n=501), and 4 ‘comparison-in-waiting group’ (CG; n=426). The MOM programme involved structured group exercise twice weekly for 12 weeks, along with health-related workshops with the groups maintained up to 52W. Primary outcome measures (aerobic fitness, bodyweight and waist circumference (WC)) together with self-administered questionnaires were used to gather participant data at baseline, 12, 26 and 52 weeks (W).
Results: Results show a net positive effect on aerobic fitness, bodyweight and WC, with significant (p<0.05) net change scores observed in the IG compared to the CG (METS: 12W=+2.20, 26W=+1.89, 52W=+0.92; Weight: 12W=-1.72kg, 26W=-1.95kg, 52W=-1.89kg; WC: 12W=-4.54cm, 26W=-2.69cm, 52W=-3.16cm). The corresponding reduction in cardiovascular disease risk is particularly significant in the context of a previously inactive and overweight cohort. The high ‘dropout’ (42.7% presenting at 52W) however, is of particular concern, with ‘dropouts’ having lower levels of aerobic fitness and higher bodyweight/WC at baseline.
Conclusions: Notwithstanding dropout issues, findings address an important gap in public health practice by informing the translational scale-up of a small controllable gender-specific PA intervention, MOM, to a national population based PA intervention targeting inactive men
Investigating experiences of the family connections programme for supporters of individuals with a diagnosis of borderline personality disorder
We interviewed relatives and carers following their participation in a novel Family Connection (FC) programme, designed for supporters of individuals with a diagnosis of Borderline Personality Disorder. A mixed methods approach was utilised to quantitatively measure depression, ‘burden’, grief and mastery, pre and post-group, whilst qualitative analysis identified four themes: ‘Positive Experience’, ‘Not Alone’, ‘Management of Emotions and Behaviours’ and ‘Recommendations’. Quantitative measures suggest that FC could be helpful in alleviating depression and ‘burden’ and increasing mastery, although it could increase the experience of grief. Implications for future research and the possible impact of FC amongst this group are discussed
A Broadband X-Ray Study of the Supernova Remnant 3C 397
We present an X-ray study of the radio bright supernova remnant (SNR) 3C 397
with ROSAT, ASCA, and RXTE. A central X-ray spot seen with the ROSAT
High-Resolution Imager hints at the presence of a pulsar-powered component, and
gives this SNR a composite X-ray morphology. Combined ROSAT and ASCA imaging
show that the remnant is highly asymmetric, with its hard X-ray emission
peaking at the western lobe. The spectrum of 3C 397 is heavily absorbed, and
dominated by thermal emission with emission lines evident from Mg, Si, S, Ar
and Fe. Single-component models fail to describe the spectrum, and at least two
components are required. We use a set of non-equilibrium ionization (NEI)
models (Borkowski et al. in preparation). The temperatures from the soft and
hard components are 0.2 keV and 1.6 keV respectively. The corresponding
ionization time-scales ( being the pre-shock hydrogen density) are
6 cm s and 6 10 cm s,
respectively. The spectrum obtained with the Proportional Counter Array (PCA)
of RXTE is contaminated by emission from the Galactic ridge, with only
15% of the count rate originating from 3C 397 in the 5-15 keV range. The PCA
spectrum allowed us to confirm the thermal nature of the hard X-ray emission. A
third component originating from a pulsar-driven component is possible, but the
contamination of the source signal by the Galactic ridge did not allow us to
find pulsations from any hidden pulsar. We discuss the X-ray spectrum in the
light of two scenarios: a young ejecta-dominated remnant of a core-collapse SN,
and a middle-aged SNR expanding in a dense ISM. Spatially resolved spectroscopy
(with CHANDRA and XMM) is needed to differentiate between the two scenarios,
and address the nature of the mysterious radio-quiet X-ray hot spot.Comment: 21 pages including 8 figures and 5 tables. Accepted for publication
in the Astrophysical journa
How are secure attachment relationships fostered through talk between teachers and students who have been adopted? A conversation analysis
Despite the growing recognition of the importance of supportive teacher–student relationships to create safety for young people who have experienced early adversity and trauma, there is not a clear understanding of what factors make for positive school relationships and how these can be fostered. The aims of the study were to explore how children with challenging emotional backgrounds are supported by their key adult in school and how this occurs in the process of conversations between them. Three student–teacher pairs from a specialist school took part in a semi-structured interview about their relationship. Data was analysed using conversation analysis. Analysis found how teaching staff use several conversational markers in talk with children with attachment difficulties when emotional experiences are raised and when troubles occur in navigating difficult conversations. Recommendations for clinical practice and future research are made. </jats:p
A Near-Infrared and X-ray Study of W49B: A Wind Cavity Explosion
We present near-infrared narrow-band images of the supernova remnant W49B,
taken with the WIRC instrument on the Hale 200 inch telescope on Mt. Palomar.
The 1.64 micron [Fe II] image reveals a barrel-shaped structure with coaxial
rings, which is suggestive of bipolar wind structures surrounding massive
stars. The 2.12 micron shocked molecular hydrogen image extends 1.9 pc outside
of the [Fe II] emission to the southeast. We also present archival Chandra
data, which show an X-ray jet-like structure along the axis of the [Fe II]
barrel, and flaring at each end. Fitting single temperature X-ray emission
models reveals: an enhancement of heavy elements, with particularly high
abundances of hot Fe and Ni, and relatively metal-rich core and jet regions. We
interpret these findings as evidence that W49B originated inside a wind-blown
bubble (R ~ 5 pc) interior to a dense molecular cloud. This suggests that
W49B's progenitor was a supermassive star, that could significantly shape its
surrounding environment. We also suggest two interpretations for the jet
morphology, abundance variations and molecular hydrogen emission: (1) the
explosion may have been jet-driven and interacting with the molecular cavity
(i.e. a Gamma-ray burst); or (2) the explosion could have been a traditional
supernova, with the jet structure being the result of interactions between the
shock and an enriched interstellar cloud.Comment: 9 pages with embedded figures Accepted by the Astrophysical Journa
The challenges facing public libraries in the Big Society: The role of volunteers, and the issues that surround their use in England
The use of volunteers in English public libraries is nothing new, however their use is becoming ever greater and one may argue that we are increasingly seeing a mixed economy of public library provision, in the wider arena of the Big Society. This paper presents the findings of a Delphi Study of 15 library managers undertaken as part of a Professional Doctorate exploring the challenges facing public libraries in England today, particularly focusing on volunteer use. An overview of relevant supporting literature is provided to help contextualize the research, particularly focusing on concepts such as the political background surrounding policy development, community engagement, the Big Society, and volunteering. Explanation of how the Delphi Study was conducted is given, together with a discussion of the key findings. Results show that opinions of library managers cover a broad spectrum. Although volunteer use is generally viewed by the respondents as a good thing, with potential to further enhance a service and aid community engagement, there are also a number of concerns. These concerns particularly relate to the idea of the volunteer as a replacement to paid staff rather than an enhancement to the service. Other key concerns relate to the quality of service provision, the rationale behind volunteer use, and the capacity of communities to deliver. Volunteer use in public libraries on this scale is a new phenomenon, and the longevity of such a development is largely unknown. This raises the question as to whether this is simply a large scale ideological experiment, or a move to even greater community engagement
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Association of daily copayments with use of hospital care among medicare advantage enrollees
Background
While the traditional Medicare program imposes a deductible for hospital admissions, many Medicare Advantage plans have instituted per-diem copayments for hospital care. Little evidence exists about the effects of changes in cost-sharing for hospital care among the elderly. Changing inpatient benefits from a deductible to a per diem may benefit enrollees with shorter lengths of stay, but adversely affect the out-of-pocket burden for hospitalized enrollees with longer lengths of stay.
Methods
We used a quasi-experimental difference-in-differences study to compare longitudinal changes in proportion hospitalized, inpatient admissions and days per 100 enrollees, and hospital length of stay between enrollees in MA plans that changed inpatient benefit from deductible at admission to per diem, intervention plans, and enrollees in matched control plans – similar plans that maintained inpatient deductibles. The study population included 423,634 unique beneficiaries enrolled in 23 intervention plans and 36 matched control plans in the 2007–2010 period.
Results
The imposition of per-diem copayments were associated with adjusted declines of 1.3 admissions/100 enrollees (95% CI − 1.8 to − 0.9), 6.9 inpatient days/100 enrollees (95% CI − 10.1 to − 3.8) and 0.7 percentage points in the probability of hospital admission (95% CI − 1.0 to − 0.4), with no significant change in adjusted length of stay in intervention plans relative to control plans. For persons with 2 or more hospitalizations in the year prior to the cost-sharing change, adjusted declines were 3.5 admissions/100 (95% CI − 8.4 to 1.4), 31.1 days/100 (95% CI − 75.2 to 13.0) and 2.2 percentage points in the probability of hospitalization (95% CI − 3.8 to − 0.6) in intervention plans relative to control plans.
Conclusions
Instituting per-diem copayments was associated with reductions in number of admissions and hospital stays, but not length of stay once admitted. Effects of inpatient cost-sharing changes were magnified for persons with greater baseline use of hospital care
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