Travelling groups stick together::How collective directional movement influences social cohesion

We tested the hypothesis that the social act of moving through space with others – collective directional movement – is associated with greater levels of group cohesion compared to static activities. We asked participants to imagine participating in activities as part of a same-sex group and found that imagining going on a journey is associated with higher levels of expected cohesion compared to imagining attending a meeting (Study 1) or an event (Study 2). Study 3 replicates the main effect using different manipulations and finds that it persists regardless of whether the imagined group were friends or strangers. Two further studies employed real-world tasks and show that the effect is not a consequence of goal-ascription (Study 4) or synchrony/exertion (Study 5).We argue that the link between this activity and cohesion is a consequence of its ubiquity in social ecologies and the interdependence and shared common fate of those engaged in it

Effectiveness and cost-effectiveness of a universal parenting skills programme in deprived communities : multicentre randomised controlled trial

Objective: To evaluate the effectiveness and cost utility of a universally provided early years parenting programme. Design: Multicentre randomised controlled trial with cost-effectiveness analysis. Setting: Early years centres in four deprived areas of South Wales. Participants: Families with children aged between 2 and 4 years. 286 families were recruited and randomly allocated to the intervention or waiting list control. Intervention: The Family Links Nurturing Programme (FLNP), a 10-week course with weekly 2 h facilitated group sessions. Main outcome measures: Negative and supportive parenting, child and parental well-being and costs assessed before the intervention, following the course (3 months) and at 9 months using standardised measures. Results: There were no significant differences in primary or secondary outcomes between trial arms at 3 or 9 months. With ‘+’ indicating improvement, difference in change in negative parenting score at 9 months was +0.90 (95%CI −1.90 to 3.69); in supportive parenting, +0.17 (95%CI −0.61 to 0.94); and 12 of the 17 secondary outcomes showed a non-significant positive effect in the FLNP arm. Based on changes in parental well-being (SF-12), the cost per quality-adjusted life year (QALY) gained was estimated to be £34 913 (range 21 485–46 578) over 5 years and £18 954 (range 11 664–25 287) over 10 years. Probability of cost per QALY gained below £30 000 was 47% at 5 years and 57% at 10 years. Attendance was low: 34% of intervention families attended no sessions (n=48); only 47% completed the course (n=68). Also, 19% of control families attended a parenting programme before 9-month follow-up. Conclusions: Our trial has not found evidence of clinical or cost utility for the FLNP in a universal setting. However, low levels of exposure and contamination mean that uncertainty remains. Trial registration: The trial is registered with Current Controlled Trials ISRCTN13919732

Créer un tableau de bord permettant de répondre aux besoins des résidents d’un programme de formation fondé sur les compétences : projet de recherche basé sur la conception

Background: Canadian specialty programs are implementing Competence By Design, a competency-based medical education (CBME) program which requires frequent assessments of entrustable professional activities. To be used for learning, the large amount of assessment data needs to be interpreted by residents, but little work has been done to determine how visualizing and interacting with this data can be supported. Within the University of Saskatchewan emergency medicine residency program, we sought to determine how our residents’ CBME assessment data should be presented to support their learning and to develop a dashboard that meets our residents’ needs. Methods: We utilized a design-based research process to identify and address resident needs surrounding the presentation of their assessment data. Data was collected within the emergency medicine residency program at the University of Saskatchewan via four resident focus groups held over 10 months. Focus group discussions were analyzed using a grounded theory approach to identify resident needs. This guided the development of a dashboard which contained elements (data, analytics, and visualizations) that support their interpretation of the data. The identified needs are described using quotes from the focus groups as well as visualizations of the dashboard elements. Results: Resident needs were classified under three themes: (1) Provide guidance through the assessment program, (2) Present workplace-based assessment data, and (3) Present other assessment data. Seventeen dashboard elements were designed to address these needs. Conclusions: Our design-based research process identified resident needs and developed dashboard elements to meet them. This work will inform the creation and evolution of CBME assessment dashboards designed to support resident learning.Contexte : Les programmes canadiens de spécialité sont à implanter la compétence par conception (CPC), un programme d’éducation médicale par compétences qui nécessite des évaluations fréquentes des activités professionnelles confiables. Pour servir aux fins d’apprentissage, la grande quantité de données d’évaluation doit être interprétée par les résidents, mais peu de travaux ont été réalisés pour déterminer comment la visualisation et l’interaction avec ces données peuvent être soutenues. Dans le cadre du programme de résidence en médecine d’urgence de l’Université de Saskatchewan, nous avons cherché à déterminer comment les données d’évaluation de la CPC de nos résidents devraient être présentées pour soutenir leur apprentissage et pour développer un tableau de bord qui réponde aux besoins de nos résidents. Méthodologie : Nous avons utilisé un processus de recherche orientée par la conception pour cerner les besoins des résidents en lien avec la présentation de leurs données d’évaluation. Les données ont été recueillies au cours du programme de résidence en médecine d’urgence de l’Université de Saskatchewan grâce à quatre groupes de discussion de résidents qui se sont tenus sur une période de 10 mois. Les groupes de discussion ont été analysés en utilisant l’approche de la théorisation ancrée (Grounded Theory) pour cerner les besoins des résidents, pour guider le développement d’un tableau de bord contenant des éléments (données, analyses et visualisations) qui soutiennent leur interprétation de leurs propres données. Les besoins identifiés sont décrits à l’aide de citations des groupes de discussion ainsi que de visualisations des éléments du tableau de bord. Résultats : Les besoins des résidents ont été classés sous trois thèmes : 1. être guidés quant au programme d'évaluation, 2. présenter des données d’évaluation en milieu de travail, et 3. présenter d’autres données d’évaluation. Dix-sept éléments du tableau de bord ont été conçus pour répondre à ces besoins. Conclusions : Notre méthode de recherche orientée par conception a permis de cerner les besoins des résidents et d’élaborer les éléments d’un tableau de bord pour y répondre. Ce travail servira de base à la création et à l’évolution des tableaux de bord d’évaluation en CPC conçus pour soutenir l’apprentissage des résidents

The effect of short duration resistance training on insulin sensitivity and muscle adaptations in overweight men

The aim of the study was to investigate the effects of 6 weeks of resistance exercise training, composed of one set of each exercise to voluntary failure, on insulin sensitivity and the time course of adaptations in muscle strength/mass. Ten overweight men (age 36 ± 8 years; height 175 ± 9 cm; weight 89 ± 14 kg; body mass index 29 ± 3 kg m−2) were recruited to the study. Resistance exercise training involved three sessions per week for 6 weeks. Each session involved one set of nine exercises, performed at 80% of one‐repetition maximum to volitional failure. Sessions lasted 15–20 min. Oral glucose tolerance tests were performed at baseline and post‐intervention. Vastus lateralis muscle thickness, knee‐extensor maximal isometric torque and rate of torque development (measured between 0 and 50, 0 and 100, 0 and 200, and 0 and 300 ms) were measured at baseline, each week of the intervention, and after the intervention. Resistance training resulted in a 16.3 ± 18.7% (P < 0.05) increase in insulin sensitivity (Cederholm index). Muscle thickness, maximal isometric torque and one‐repetition maximum increased with training, and at the end of the intervention were 10.3 ± 2.5, 26.9 ± 8.3, 18.3 ± 4.5% higher (P < 0.05 for both) than baseline, respectively. The rate of torque development at 50 and 100 ms, but not at 200 and 300 ms, increased (P < 0.05) over the intervention period. Six weeks of single‐set resistance exercise to failure results in improvements in insulin sensitivity and increases in muscle size and strength in young overweight men

The determination of salivary oxypurines before and after exercise by combined liquid chromatography-field asymmetric waveform ion mobility spectrometry-time-of-flight mass spectrometry

© 2018 Springer-Verlag GmbH Germany, part of Springer Nature A method combining field asymmetric waveform ion mobility spectrometry with liquid chromatography-mass spectrometry (LC-FAIMS-MS) has been developed for the analysis of the oxypurine compounds hypoxanthine (HX) and xanthine (XA) in saliva. Separation of the oxypurines from interfering matrix components was investigated using FAIMS-MS. The selected FAIMS parameters were then applied to the rapid LC-FAIMS-MS analysis of HX and XA using a short chromatographic separation method (7 min). A comparison of the LC-MS method with and without FAIMS applied, resulted in improved discrimination from saliva matrix interferences and improved chromatographic peak integration for both HX and XA using a FAIMS separation. A quantitative evaluation of the LC-FAIMS-MS method was performed giving limits of detection of 2.0 ng mL −1 for HX and 1.8 ng mL −1 for XA, and limits of quantification of 6.6 ng mL −1 for HX and 6.0 ng mL −1 for XA. The developed LC-FAIMS-MS method was applied to the targeted analysis of the oxypurine metabolites in saliva collected from healthy male athletes (n = 11) before and after exercise designed to induce oxidative stress; post-exercise collection time-points included immediately after exercise, one hour and twenty-four hours’ post-exercise. The salivary concentrations of both HX and XA were lower after physical exercise, compared to the pre-exercise (rest) concentrations and returned to approximately pre-exercise levels after twenty-four hours. The method reported has the potential for monitoring the salivary oxypurines, HX and XA, as biomarkers of oxidative stress and in other clinical applications

Measuring the impact and costs of a universal group based parenting programme : protocol and implementation of a trial

Background Sub-optimal parenting is a common risk factor for a wide range of negative health, social and educational outcomes. Most parenting programmes have been developed in the USA in the context of delinquency prevention for targeted or indicated groups and the main theoretical underpinning for these programmes is behaviour management. The Family Links Nurturing Programme (FLNP) focuses on family relationships as well as behaviour management and is offered on a universal basis. As a result it may be better placed to improve health and educational outcomes. Developed in the UK voluntary sector, FLNP is popular with practitioners, has impressed policy makers throughout the UK, has been found to be effective in before/after and qualitative studies, but lacks a randomised controlled trial (RCT) evidence base. Methods/Design A multi-centre, investigator blind, randomised controlled trial of the FLNP with a target sample of 288 south Wales families who have a child aged 2-4 yrs living in or near to Flying Start/Sure Start areas. Changes in parenting, parent child relations and parent and child wellbeing are assessed with validated measures immediately and at 6 months post intervention. Economic components include cost consequences and cost utility analyses based on parental ranking of states of quality of life. Attendance and completion rates and fidelity to the FLNP course delivery are assessed. A nested qualitative study will assess reasons for participation and non-participation and the perceived value of the programme to families. By the end of May 2010, 287 families have been recruited into the trial across four areas of south Wales. Recruitment has not met the planned timescales with barriers including professional anxiety about families entering the control arm of the trial, family concern about video and audio recording, programme facilitator concern about the recording of FLNP sessions for fidelity purposes and delays due to the new UK research governance procedures. Discussion Whilst there are strong theoretical arguments to support universal provision of parenting programmes, few universal programmes have been subjected to randomised controlled trials. In this paper we describe a RCT protocol with quantitative and qualitative outcome measures and an economic evaluation designed to provide clear evidence with regard to effectiveness and costs. We describe challenges implementing the protocol and how we are addressing these

Treatments for irritable bowel syndrome: patients' attitudes and acceptability

<p>Abstract</p> <p>Background</p> <p>Irritable Bowel Syndrome, a highly prevalent chronic disorder, places significant burden on the health service and the individual. Symptomatic distress and reduced quality of life are compounded by few efficacious treatments available. As researchers continue to demonstrate the clinical efficacy of alternative therapies, it would be useful to gain a patient-perspective of treatment acceptability and identify patient's attitudes towards those modalities considered not acceptable.</p> <p>Methods</p> <p>Six hundred and forty-five participants identified from an earlier IBS-prevalence study received a postal questionnaire to evaluate preferences and acceptability of nine forms of treatment. Proportions accepting each form of treatment were calculated and thematic analysis of qualitative data undertaken.</p> <p>Results</p> <p>A total of 256 (39.7%) of 645 potential respondents completed the questionnaire (mean age 55.9 years, 73% female). Tablets were most acceptable (84%), followed by lifestyle changes (diet (82%), yoga (77%)). Acupuncture (59%) and suppositories (57%) were less acceptable.</p> <p>When explaining lack of acceptability, patient views fell into four broad categories: dislike treatment modality, do not perceive benefit, general barriers and insufficient knowledge. Scepticism, lack of scientific rationale and fear of CAM were mentioned, although others expressed a dislike of conventional medical treatments. Past experiences, age and health concerns, and need for proof of efficacy were reported.</p> <p>Conclusion</p> <p>Most patients were willing to accept various forms of treatment. However, the reservations expressed by this patient-population must be recognised with particular focus directed towards allaying fears and misconceptions, seeking further evidence base for certain therapies and incorporating physician support and advice.</p

Paramedic assessment of older adults after falls, including community care referral pathway : cluster randomized trial

Study objective We aim to determine clinical and cost-effectiveness of a paramedic protocol for the care of older people who fall. Methods We undertook a cluster randomized trial in 3 UK ambulance services between March 2011 and June 2012. We included patients aged 65 years or older after an emergency call for a fall, attended by paramedics based at trial stations. Intervention paramedics could refer the patient to a community-based falls service instead of transporting the patient to the emergency department. Control paramedics provided care as usual. The primary outcome was subsequent emergency contacts or death. Results One hundred five paramedics based at 14 intervention stations attended 3,073 eligible patients; 110 paramedics based at 11 control stations attended 2,841 eligible patients. We analyzed primary outcomes for 2,391 intervention and 2,264 control patients. One third of patients made further emergency contacts or died within 1 month, and two thirds within 6 months, with no difference between groups. Subsequent 999 call rates within 6 months were lower in the intervention arm (0.0125 versus 0.0172; adjusted difference –0.0045; 95% confidence interval –0.0073 to –0.0017). Intervention paramedics referred 8% of patients (204/2,420) to falls services and left fewer patients at the scene without any ongoing care. Intervention patients reported higher satisfaction with interpersonal aspects of care. There were no other differences between groups. Mean intervention cost was $23 per patient, with no difference in overall resource use between groups at 1 or 6 months. Conclusion A clinical protocol for paramedics reduced emergency ambulance calls for patients attended for a fall safely and at modest cost