Maggot debridement therapy in chronic wound care

Objective: To review the current evidence on the mechanism of actions and clinical applications of maggot debridement therapy. Data sources: Literature search of PubMed and Medline was performed up to January 2007. Study selection: Original and major review articles related to maggot debridement therapy were reviewed. Key words used in the literature search were 'maggot debridement therapy', 'wound healing', and 'chronic wound management'. Data extraction: All relevant English and Chinese articles. Data synthesis: The mechanism of such maggot therapy was shown to be due to the debridement, disinfection, and wound healing enhancement actions of maggot excretions/secretions. The efficacy of maggot debridement therapy in chronic wound management has been demonstrated in chronic venous ulcers, pressure ulcers, and diabetic ulcers. There is also a new delivery system for the excretions/secretions, which has been shown to be as effective as using live maggots. Conclusions: Maggot debridement therapy has been shown to be a safe and effective means of chronic wound management. However, there are a number of limitations when considering its local applicability. Future development of the delivery system may help to overcome some of these limitations and improve its acceptability.published_or_final_versio

A Meta-Analysis of Self-Determination Theory-Informed Intervention Studies in the Health Domain: Effects on Motivation, Health Behavior, Physical, and Psychological Health

There are no literature reviews that have examined the impact of health-domain interventions, informed by self-determination theory (SDT), on SDT constructs and health indices. Our aim was to meta-analyse such interventions in the health promotion and disease management literatures. Studies were eligible if they used an experimental design, tested an intervention that was based on SDT, measured at least one SDT-based motivational construct, and at least one indicator of health behaviour, physical health, or psychological health. Seventy-three studies met these criteria and provided sufficient data for the purposes of the review. A random-effects meta-analytic model showed that SDT-based interventions produced small-to-medium changes in most SDT constructs at the end of the intervention period, and in health behaviours at the end of the intervention period and at the follow-up. Small positive changes in physical and psychological health outcomes were also observed at the end of the interventions. Increases in need support and autonomous motivation (but not controlled motivation or amotivation) were associated with positive changes in health behaviour. In conclusion, SDT-informed interventions positively affect indices of health; these effects are modest, heterogeneous, and partly due to increases in self-determined motivation and support from social agents

Stirring the motivational soup: Within-person latent profiles of motivation in exercise

Background: The purpose of the present study was to use a person-oriented analytical approach to identify latent motivational profiles, based on the different behavioural regulations for exercise, and to examine differences in satisfaction of basic psychological needs (competence, autonomy and relatedness) and exercise behaviour across these motivational profiles. Methods: Two samples, consisting of 1084 and 511 adults respectively, completed exercise-related measures of behavioural regulation and psychological need satisfaction as well as exercise behaviour. Latent profile analyses were used to identify motivational profiles. Results: Six profiles, representing different combinations of regulations for exercise, were found to best represent data in both samples. Some profiles were found in both samples (e.g., low motivation profile, self-determined motivation profile and self-determined with high introjected regulation profile), whereas others were unique to each sample. In line with the Self-Determination Theory, individuals belonging to more self-determined profiles demonstrated higher scores on need satisfaction. Conclusions: The results support the notions of motivation being a multidimensional construct and that people have different, sometimes competing, reasons for engaging in exercise. The benefits of using person-oriented analyses to examine within-person interactions of motivation and different regulations are discussed. © 2017 The Author(s)

Combining motivational and volitional approaches to reducing excessive alcohol consumption in pre-drinkers: A theory-based intervention protocol

Background: Pre-drinking refers to the consumption of alcohol at home or a private residence prior to attending a subsequent social event. We present the study protocol of an online theory-based intervention to reduce pre-drinking and related harm in pre-drinking undergraduates, using behavior change techniques targeting the motivational and volitional phases of behaviour. Design: A fully randomized 2 (autonomy support: present vs. absent) x 2 (implementation intention: present vs. absent) between-participants design will be used to ascertain the effectiveness of the intervention in reducing pre-drinking alcohol consumption and alcohol-related harm. Participants will complete a range of theory-based measures prior to being allocated to one of the four experimental conditions. Four weeks later, participants will complete a follow-up questionnaire comprised of theoretical and behavioral measures. Analyses: The main and interactive effects of the intervention components in reducing our primary dependent variables, namely, pre-drinking alcohol consumption and alcohol-related harm at four-week follow-up will be tested. Baseline alcohol consumption and demographic information will be included in the analysis as covariates. Discussion: This online intervention is the first to be developed to reduce pre-drinking alcohol consumption, a behaviour linked to increased risk of alcohol-related harm. The intervention targets motivational and volitional components of the behaviour change process and is therefore likely to lead to greater reductions in pre-drinking alcohol consumption and experience of alcohol-related harm compared to either approach in isolation. If successful, the intervention can be implemented across various contexts and in populations where pre-drinking is prevalent. © 2016 Caudwell et al

Variations in adolescents’ motivational characteristics across gender and physical activity patterns: A latent class analysis approach

Abstract Background Neglecting to take account of the underlying context or type of physical activity (PA) that underpins overall involvement has resulted in a limited understanding of adolescents’ PA participation. The purpose of the present research was to identify male and female adolescents’ leisure time PA patterns and examine whether psychological processes derived from self-determination theory differ as a function of the pattern of PA undertaken. Methods Nine hundred ninety-five students (61.2% females, 38.8% males; M age = 13.72 years, SD = 1.25) from eight secondary schools in Dublin, Ireland completed a physical activity recall 7 day diary and measures of intrinsic motivation, competence, relatedness, autonomy and autonomy support. Based on the diary five binary indicators of physical activity were derived reflecting recommended levels of MVPA on a minimum of 3 days, at least three sessions of non-organized physical activity (e.g. jog), team sport, individual sport, and organized non-sport physical activity (e.g. dance). Latent class analysis was used to identify subgroups of adolescents that engaged in similar patterns of physical activity. Profiles of physical activity participation were subsequently compared on motivational characteristics using Kruskal-Wallis tests. Results Latent class analysis revealed six distinct classes for girls (Organized Run/Swim & Dance/Gym; Organized Dance; Leisure Active Team Sport; Active Individual Sport; Walk/Run/Outdoor games; Non-Participation) and five for boys (Leisure Active Gym; Leisure Active Individual Sport; Active Team Sport; Active Mixed Type; Non-Participation). Significant differences were found between the classes. Girls characterized by participation in team or individual sport, and boys represented by team sport participation demonstrated significantly higher self-determined motivational characteristics relative to other profiles of physical activity. Conclusion This research offers a nuanced insight into the underlying type of activities that constitute overall patterns of PA among adolescent boys and girls and further reveals that psychological processes vary dependent on the profile of physical activity undertaken. The findings may be useful for informing interventions aimed at promoting physical activity among young people

Team Sport in the Workplace? A RE-AIM Process Evaluation of ‘Changing the Game’

Background: The workplace is a priority setting to promote health. Team sports can be an effective way to promote both physical and social health. This study evaluated the potential enablers and barriers for outcomes of a workplace team sports intervention programme‘Changing the Game’ (CTG). This study was conducted in a FTSE 100 services organisation. This process evaluation was conducted using the RE-AIM framework. Methods: A mixed methods approach was used. Data were collected from the participants in the intervention group prior to, during and at the end of the intervention using interviews (n = 12), a focus group (n = 5), and questionnaires (n = 17). Organisational documentation was collected, and a research diary was recorded by the lead author. The evidence collected was triangulated to examine the reach, efficacy, adoption, implementation and maintenance of the programme. Data was assessed through template analysis, and questionnaire data were analysed using multiple regression and a series of univariate ANOVAs. Results: CTG improved VO2 Max, interpersonal communication, and physical activity behaviour (efficacy) over 12-weeks. This may be attributed to the supportive approach adopted within the design and delivery of the programme (implementation). Individual and organisational factors challenged the adoption and maintenance of the intervention. The recruitment and communication strategy limited the number of employees the programme could reach. Conclusion: The process evaluation suggests addressing the culture within workplaces may better support the reach, adoption and maintenance of workplace team sport programmes. Future research should consider investigating and applying these findings across a range of industries and sectors

Clinicopathological Conference

Conference Theme: From Bench Research to Patient CareSession 4: Clinical Research Presentation

Preliminary evidence on the measurement properties of the Chinese version of the child health questionnaire, parent form (CHQ-PF50) and child form (CHQ-CF87)

The objective of this study was to evaluate the reliability and construct validity of the Chinese parent form (PF50) and child form (CF87) of the Child Health Questionnaire (CHQ). Methods: To assess the construct validity and reliability of the Chinese versions, we invited 1099 parents of healthy children and 816 school children to complete the Chinese CHQ-PF50 and CHQ-CF87, respectively. Results: Psychometric analysis on item convergent validity and discriminant validity showed ≥99% rates of success for all 10 scales in the CF87 and ≥94% for all but one scale in the PF50, the exception being general health scale (86%). We observed minimal floor effects for both questionnaires, but substantial ceiling effects for five scales in both the PF50 and CF87 (physical functioning, role-emotional/behavioral, role-physical, bodily pain and family activities). A substantially lower ceiling effect was observed for the physical scale and bodily pain in the CF87 (19% and 25%, respectively) relative to the PF50 (46% and 42%, respectively). The median alpha coefficient for CF87 and PF50 was 0.90 (range, 0.80-0.94) and 0.78 (range, 0.44-0.88), respectively. Conclusions: Our findings suggest that the Chinese CHQ-PF50 and CHQ-CF87 are robust and sufficiently reliable for group comparisons and perhaps also for use in other Chinese populations. © Springer 2005.link_to_subscribed_fulltex