Examining methods, messengers and behavioural theories to disseminate physical activity information to individuals with a diagnosis of schizophrenia: a scoping review

Background: Many individuals with a diagnosis of schizophrenia are not active and lack the necessary knowledge and confidence to become and stay active. To develop effective physical activity promotion interventions, it is necessary to identify credible messengers and effective methods to disseminate physical activity information to this population. Aims: The purpose of this scoping review was to identify and examine knowledge mobilization theories, messengers and methods used to disseminate physical activity information to individuals with a diagnosis of schizophrenia. Method: This scoping review followed the methodological framework proposed by Arksey and O'Malley. Results: In total, 43 studies and 7 reviews identified multiple messengers and methods used to disseminate physical activity information to individuals with a diagnosis of schizophrenia, but few attempts to structure information theoretically. Findings do not point to which messengers or methods are most effective or which theories should be used to construct information interventions. Studies show that physical activity information should be provided in an individualised manner from staff who could easily connect with patients. Conclusions: Few researchers have addressed the physical activity information needs of individuals with a diagnosis of schizophrenia. Researchers need to examine and implement effective knowledge mobilization strategies for this population

Treatment of Idiopathic Pulmonary Fibrosis With Ambrisentan

Background: Idiopathic pulmonary fibrosis (IPF) is characterized by formation and proliferation of fibroblast foci. Endothelin-1 induces lung fibroblast proliferation and contractile activity via the endothelin A (ETA) receptor. Objective: To determine whether ambrisentan, an ETA receptor- selective antagonist, reduces the rate of IPF progression. Design: Randomized, double-blind, placebo-controlled, eventdriven trial. (ClinicalTrials.gov: NCT00768300) Setting: Academic and private hospitals. Participants: Patients with IPF aged 40 to 80 years with minimal or no honeycombing on high-resolution computed tomography scans. Intervention: Ambrisentan, 10 mg/d, or placebo. Measurements: Time to disease progression, defined as death, respiratory hospitalization, or a categorical decrease in lung function. Results: The study was terminated after enrollment of 492 patients (75% of intended enrollment; mean duration of exposure to study medication, 34.7 weeks) because an interim analysis indicated a low likelihood of showing efficacy for the end point by the scheduled end of the study. Ambrisentan-treated patients were more likely to meet the prespecified criteria for disease progression (90 [27.4%] vs. 28 [17.2%] patients; P = 0.010; hazard ratio, 1.74 [95% CI, 1.14 to 2.66]). Lung function decline was seen in 55 (16.7%) ambrisentan-treated patients and 19 (11.7%) placebotreated patients (P = 0.109). Respiratory hospitalizations were seen in 44 (13.4%) and 9 (5.5%) patients in the ambrisentan and placebo groups, respectively (P =0.007). Twenty-six (7.9%) patients who received ambrisentan and 6 (3.7%) who received placebo died (P = 0.100). Thirty-two (10%) ambrisentan-treated patients and 16 (10%) placebo-treated patients had pulmonary hypertension at baseline, and analysis stratified by the presence of pulmonary hypertension revealed similar results for the primary end point. Limitation: The study was terminated early. Conclusion: Ambrisentan was not effective in treating IPF and may be associated with an increased risk for disease progression and respiratory hospitalizations. Primary Funding Source: Gilead Sciences. © 2013 American College of Physicians