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

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

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

Developing implementation research capacity: longitudinal evaluation of the King's College London Implementation Science Masterclass, 2014-2019.

BACKGROUND: Despite an increasing number of training opportunities in implementation science becoming available, the demand for training amongst researchers and practitioners is unmet. To address this training shortfall, we developed the King's College London 'Implementation Science Masterclass' (ISM), an innovative 2-day programme (and currently the largest of its kind in Europe), developed and delivered by an international faculty of implementation experts. METHODS: This paper describes the ISM and provides delegates' quantitative and qualitative evaluations (gathered through a survey at the end of the ISM) and faculty reflections over the period it has been running (2014-2019). RESULTS: Across the 6-year evaluation, a total of 501 delegates have attended the ISM, with numbers increasing yearly from 40 (in 2014) to 147 (in 2019). Delegates represent a diversity of backgrounds and 29 countries from across the world. The overall response rate for the delegate survey was 64.5% (323/501). Annually, the ISM has been rated 'highly' in terms of delegates' overall impression (92%), clear and relevant learning objectives (90% and 94%, respectively), the course duration (85%), pace (86%) and academic level 87%), and the support provided on the day (92%). Seventy-one percent of delegates reported the ISM would have an impact on how they approached their future work. Qualitative feedback revealed key strengths include the opportunities to meet with an international and diverse pool of experts and individuals working in the field, the interactive nature of the workshops and training sessions, and the breadth of topics and contexts covered. CONCLUSIONS: Yearly, the UK ISM has grown, both in size and in its international reach. Rated consistently favourably by delegates, the ISM helps to tackle current training demands from all those interested in learning and building their skills in implementation science. Evaluation of the ISM will continue to be an annual iterative process, reflective of changes in the evidence base and delegates changing needs as the field evolves

Metastatic meningioma: positron emission tomography CT imaging findings

The imaging findings of a case of metastasing meningioma are described. The case illustrates a number of rare and interesting features. The patient presented with haemoptysis 22 years after the initial resection of an intracranial meningioma. CT demonstrated heterogeneous masses with avid peripheral enhancement without central enhancement. Blood supply to the larger lesion was partially from small feeding vessels from the inferior pulmonary vein. These findings correlate with a previously published case in which there was avid uptake of fluoro-18-deoxyglucose peripherally with lesser uptake centrally. The diagnosis of metastasing meningioma was confirmed on percutaneous lung tissue biopsy

Metastatic meningioma: positron emission tomography CT imaging findings

The imaging findings of a case of metastasing meningioma are described. The case illustrates a number of rare and interesting features. The patient presented with haemoptysis 22 years after the initial resection of an intracranial meningioma. CT demonstrated heterogeneous masses with avid peripheral enhancement without central enhancement. Blood supply to the larger lesion was partially from small feeding vessels from the inferior pulmonary vein. These findings correlate with a previously published case in which there was avid uptake of fluoro-18-deoxyglucose peripherally with lesser uptake centrally. The diagnosis of metastasing meningioma was confirmed on percutaneous lung tissue biopsy

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

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

Reaching beyond the ‘worried well’: pre-adoption characteristics of participants in ‘Men on the Move’, a community-based physical activity programme

Background Issues surrounding gender and men’s health have become an increasing focus of public health globally. Unhealthy lifestyles and lower engagement in health promotion initiatives contributed to lower life expectancy and higher mortality rates among men. This study presents the pre-adoption characteristics of men who registered for ‘Men on the Move’—a community-based physical activity (CBPA) programme, to ascertain whether the programme reached its intended target group, i.e. ‘at-risk’ adult men who did not meet physical activity (PA) guidelines and were likely to have multiple risk factors for cardiovascular disease (CVD). Methods Multiple recruitment strategies were adopted to engage the target group and baseline data collection included a range of demographic, self-report and outcome measures. Results The recruitment strategy succeeded in reaching the target group, with the majority (n = 927) presenting being previously inactive (89.0%), overweight/obese (89.7%) and having multiple CVD risk factors (53.1% ≥ 2 risk factors). However, the strategy was less successful in engaging ‘hard-to-reach’ groups, with the majority being middle-aged, white, married/cohabiting, educated and employed. Conclusions A gender-sensitized, partnership and community outreach recruitment strategy can maximize the reach and recruitment of an ‘at-risk’ cohort for CBPA initiatives, but more targeted approaches are needed to recruit marginalized groups of men