179 research outputs found
Using Intervention Mapping in the Systematic Development of a Behaviour Change Intervention to Enhance Exercise Adherence among People with Persistent Musculoskeletal Pain
Purpose: This article describes the first four steps of the intervention mapping framework used to design a programme aimed at increasing adherence to prescribed exercise by people with persistent musculoskeletal pain. Method: In Step 1, a systematic review and qualitative study was completed to inform Step 2 and the identification of the Health Action Process Approach as an appropriate theoretical framework for establishing two programme objectives: enhancing self-management and providing tailored and accessible exercise instructions. Step 3 encompassed the selection of the programme methods, and the programme is described in Step 4. The resulting programme provides virtually delivered motivational interviewing and an app-based exercise programme to support individualsâ adherence to exercise. Results: The resulting intervention was assessed in a proof-of-concept feasibility and acceptability study and was shown to be feasible and acceptable. Refinements to the programme included additional tailoring of the exercise app and modifying the motivational interviewing schedule. Conclusions: Using the intervention mapping approach enabled us to successfully develop an intervention aimed at supporting the development of self-management behaviours and addressing maladaptive beliefs as a means of enhancing individualsâ adherence to exercise. Evaluation and implementation of the intervention should now be carried out.
Objectif : dĂ©crire les quatre premiĂšres Ă©tapes du cadre de modĂ©lisation dâune intervention, utilisĂ© pour concevoir un programme visant Ă accroĂźtre lâadhĂ©sion Ă une prescription dâexercices chez les personnes souffrant de douleurs musculosquelettiques persistantes. MĂ©thodologie : Ă la premiĂšre Ă©tape, les chercheurs ont effectuĂ© une analyse systĂ©matique et une Ă©tude qualitative pour Ă©tayer la deuxiĂšme Ă©tape et dĂ©terminer le processus dâaction en santĂ© dans un cadre thĂ©orique appropriĂ© qui permettrait de formuler les deux objectifs du programme : amĂ©liorer lâautogestion et fournir des directives dâexercices adaptĂ©es et accessibles. LâĂ©tape trois englobait le choix de la mĂ©thodologie du programme, dĂ©crite Ă lâĂ©tape quatre. Le programme qui en dĂ©coule comprend des entrevues motivationnelles virtuelles et un programme dâexercices fondĂ© sur une application pour renforcer lâadhĂ©sion Ă lâexercice. RĂ©sultats : lâintervention obtenue, Ă©valuĂ©e dans une Ă©tude de validation de la faisabilitĂ© et de lâacceptabilitĂ©, sâest rĂ©vĂ©lĂ©e faisable et acceptable. Les amĂ©liorations au programme ont inclus de nouvelles adaptations Ă lâapplication dâexercices et des modifications au calendrier dâentrevues motivationnelles. Conclusion : grĂące Ă la dĂ©marche de modĂ©lisation de lâintervention, il a Ă©tĂ© possible dâĂ©laborer une intervention visant Ă promouvoir lâacquisition de comportements dâautogestion et Ă corriger des convictions mĂ©sadaptĂ©es pour accroĂźtre lâadhĂ©sion Ă lâexercice. Il reste maintenant Ă Ă©valuer et Ă mettre en Ćuvre lâintervention
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Behaviour change techniques associated with adherence to prescribed exercise in patients with persistent musculoskeletal pain: Systematic review.
PURPOSE: Exercise (planned, structured, repetitive movement) improves pain and function in people with persistent musculoskeletal pain (PMSK), but adherence is often poor. This systematic review evaluates the evidence from randomized controlled trials (RCTs) on the effectiveness of interventions to improve exercise adherence in people with PMSK and describes the content, context, and theoretical underpinning of behaviour change interventions designed to increase adherence. METHODS: Nine electronic databases were searched from inception dates to August 2017. Studies were included if they were RCTs that included adults with PMSK â„3 months; â„one measure of exercise adherence, exercise prescribed to both groups, and employed â„one behaviour change technique (BCT) in the treatment group. Independent data extraction, theory coding, BCT taxonomy coding, and quality assessment using Cochrane Risk of Bias (RoB) tool was conducted by two reviewers. RESULTS: Eight RCTs (five low, three high RoB) met inclusion criteria. Five trials reported between-group differences in exercise adherence, favouring the treatment group. Three trials reported theoretical underpinning. There was moderate evidence that five BCTs, social support, goal setting, instruction of behaviour, demonstration of behaviour, and practice/rehearsal, improved exercise adherence. Interventions employing â€seven BCTs, unique to those included in the control group, were most effective at enhancing exercise adherence. CONCLUSIONS: Limited moderate-quality evidence supports using a small number of BCTs to enhance exercise adherence in people with PMSK. Further research should explore the associations and synergies between BCTs and explicitly report how theory was utilized. This may inform recommendations for health care professionals working with this population. Statement of contribution What is already known on this subject? Exercise (i.e., planned, structured, repetitive movements) improves pain and function in people with persistent musculoskeletal pain (PMSK). Many people with PMSK do not adhere to exercises prescribed by a health care professional. Little research has explored how to enhance adherence to prescribed exercise in people with PMSK. What does this study add? Moderate-quality evidence from eight trials suggests behaviour change interventions enhance exercise adherence. Social support, goal setting, demonstration, instruction, and rehearsal were employed in effective interventions. Interventions with â€7 behaviour change techniques were more effective at improving adherence than those employing >7
Correlations of Behavioral Deficits with Brain Pathology Assessed through Longitudinal MRI and Histopathology in the R6/2 Mouse Model of HD
Huntington's disease (HD) is caused by the expansion of a CAG repeat in the huntingtin (HTT) gene. The R6/2 mouse model of HD expresses a mutant version of exon 1 HTT and develops motor and cognitive impairments, a widespread huntingtin (HTT) aggregate pathology and brain atrophy. Despite the vast number of studies that have been performed on this model, the association between the molecular and cellular neuropathology with brain atrophy, and with the development of behavioral phenotypes remains poorly understood. In an attempt to link these factors, we have performed longitudinal assessments of behavior (rotarod, open field, passive avoidance) and of regional brain abnormalities determined through magnetic resonance imaging (MRI) (whole brain, striatum, cortex, hippocampus, corpus callosum), as well as an end-stage histological assessment. Detailed correlative analyses of these three measures were then performed. We found a gender-dependent emergence of motor impairments that was associated with an age-related loss of regional brain volumes. MRI measurements further indicated that there was no striatal atrophy, but rather a lack of striatal growth beyond 8 weeks of age. T2 relaxivity further indicated tissue-level changes within brain regions. Despite these dramatic motor and neuroanatomical abnormalities, R6/2 mice did not exhibit neuronal loss in the striatum or motor cortex, although there was a significant increase in neuronal density due to tissue atrophy. The deposition of the mutant HTT (mHTT) protein, the hallmark of HD molecular pathology, was widely distributed throughout the brain. End-stage histopathological assessments were not found to be as robustly correlated with the longitudinal measures of brain atrophy or motor impairments. In conclusion, modeling pre-manifest and early progression of the disease in more slowly progressing animal models will be key to establishing which changes are causally related. © 2013 Rattray et al
An ontology-based nurse call management system (oNCS) with probabilistic priority assessment
<p>Abstract</p> <p>Background</p> <p>The current, place-oriented nurse call systems are very static. A patient can only make calls with a button which is fixed to a wall of a room. Moreover, the system does not take into account various factors specific to a situation. In the future, there will be an evolution to a mobile button for each patient so that they can walk around freely and still make calls. The system would become person-oriented and the available context information should be taken into account to assign the correct nurse to a call.</p> <p>The aim of this research is (1) the design of a software platform that supports the transition to mobile and wireless nurse call buttons in hospitals and residential care and (2) the design of a sophisticated nurse call algorithm. This algorithm dynamically adapts to the situation at hand by taking the profile information of staff members and patients into account. Additionally, the priority of a call probabilistically depends on the risk factors, assigned to a patient.</p> <p>Methods</p> <p>The <it>ontology-based Nurse Call System (oNCS) </it>was developed as an extension of a <it>Context-Aware Service Platform</it>. An ontology is used to manage the profile information. Rules implement the novel nurse call algorithm that takes all this information into account. Probabilistic reasoning algorithms are designed to determine the priority of a call based on the risk factors of the patient.</p> <p>Results</p> <p>The <it>oNCS </it>system is evaluated through a prototype implementation and simulations, based on a detailed dataset obtained from Ghent University Hospital. The arrival times of nurses at the location of a call, the workload distribution of calls amongst nurses and the assignment of priorities to calls are compared for the <it>oNCS </it><it>system </it>and the current, place-oriented nurse call system. Additionally, the performance of the system is discussed.</p> <p>Conclusions</p> <p>The execution time of the nurse call algorithm is on average 50.333 ms. Moreover, the <it>oNCS system </it>significantly improves the assignment of nurses to calls. Calls generally have a nurse present faster and the workload-distribution amongst the nurses improves.</p
Observation of associated near-side and away-side long-range correlations in âsNN=5.02ââTeV proton-lead collisions with the ATLAS detector
Two-particle correlations in relative azimuthal angle (ÎÏ) and pseudorapidity (Îη) are measured in âsNN=5.02ââTeV p+Pb collisions using the ATLAS detector at the LHC. The measurements are performed using approximately 1ââÎŒb-1 of data as a function of transverse momentum (pT) and the transverse energy (ÎŁETPb) summed over 3.1<η<4.9 in the direction of the Pb beam. The correlation function, constructed from charged particles, exhibits a long-range (2<|Îη|<5) ânear-sideâ (ÎÏâŒ0) correlation that grows rapidly with increasing ÎŁETPb. A long-range âaway-sideâ (ÎÏâŒÏ) correlation, obtained by subtracting the expected contributions from recoiling dijets and other sources estimated using events with small ÎŁETPb, is found to match the near-side correlation in magnitude, shape (in Îη and ÎÏ) and ÎŁETPb dependence. The resultant ÎÏ correlation is approximately symmetric about Ï/2, and is consistent with a dominant cosâĄ2ÎÏ modulation for all ÎŁETPb ranges and particle pT
Search for the neutral Higgs bosons of the minimal supersymmetric standard model in pp collisions at root s=7 TeV with the ATLAS detector
A search for neutral Higgs bosons of the Minimal Supersymmetric Standard Model (MSSM) is reported. The analysis is based on a sample of proton-proton collisions at a centre-of-mass energy of 7TeV recorded with the ATLAS detector at the Large Hadron Collider. The data were recorded in 2011 and correspond to an integrated luminosity of 4.7 fb-1 to 4.8 fb-1. Higgs boson decays into oppositely-charged muon or Ï lepton pairs are considered for final states requiring either the presence or absence of b-jets. No statistically significant excess over the expected background is observed and exclusion limits at the 95% confidence level are derived. The exclusion limits are for the production cross-section of a generic neutral Higgs boson, Ï, as a function of the Higgs boson mass and for h/A/H production in the MSSM as a function of the parameters mA and tan ÎČ in the mhmax scenario for mA in the range of 90GeV to 500 GeV. Copyright CERN
Search for R-parity-violating supersymmetry in events with four or more leptons in sqrt(s) =7 TeV pp collisions with the ATLAS detector
A search for new phenomena in final states with four or more leptons (electrons or muons) is presented. The analysis is based on 4.7 fbâ1 of proton-proton collisions delivered by the Large Hadron Collider and recorded with the ATLAS detector. Observations are consistent with Standard Model expectations in two signal regions: one that requires moderate values of missing transverse momentum and another that requires large effective mass. The results are interpreted in a simplified model of R-parity-violating supersymmetry in which a 95% CL exclusion region is set for charged wino masses up to 540 GeV. In an R-parity-violating MSUGRA/CMSSM model, values of m 1/2 up to 820 GeV are excluded for 10 < tan ÎČ < 40
Search for high-mass resonances decaying to dilepton final states in pp collisions at sâ=7 TeV with the ATLAS detector
The ATLAS detector at the Large Hadron Collider is used to search for high-mass resonances decaying to an electron-positron pair or a muon-antimuon pair. The search is sensitive to heavy neutral ZâČ gauge bosons, Randall-Sundrum gravitons, Z * bosons, techni-mesons, Kaluza-Klein Z/Îł bosons, and bosons predicted by Torsion models. Results are presented based on an analysis of pp collisions at a center-of-mass energy of 7 TeV corresponding to an integrated luminosity of 4.9 fbâ1 in the e + e â channel and 5.0 fbâ1 in the ÎŒ + ÎŒ âchannel. A Z âČ boson with Standard Model-like couplings is excluded at 95 % confidence level for masses below 2.22 TeV. A Randall-Sundrum graviton with coupling k/MPl=0.1 is excluded at 95 % confidence level for masses below 2.16 TeV. Limits on the other models are also presented, including Technicolor and Minimal ZâČ Models
A Genome Wide Association Scan of Bovine Tuberculosis Susceptibility in Holstein-Friesian Dairy Cattle
peer-reviewedBackground: Bovine tuberculosis is a significant veterinary and financial problem in many parts of the world. Although
many factors influence infection and progression of the disease, there is a host genetic component and dissection of this
may enlighten on the wider biology of host response to tuberculosis. However, a binary phenotype of presence/absence of
infection presents a noisy signal for genomewide association study.
Methodology/Principal Findings: We calculated a composite phenotype of genetic merit for TB susceptibility based on
disease incidence in daughters of elite sires used for artificial insemination in the Irish dairy herd. This robust measure was
compared with 44,426 SNP genotypes in the most informative 307 subjects in a genome wide association analysis. Three
SNPs in a 65 kb genomic region on BTA 22 were associated (i.e. p,1025, peaking at position 59588069, p = 4.0261026) with
tuberculosis susceptibility.
Conclusions/Significance: A genomic region on BTA 22 was suggestively associated with tuberculosis susceptibility; it
contains the taurine transporter gene SLC6A6, or TauT, which is known to function in the immune system but has not
previously been investigated for its role in tuberculosis infection
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