Exploring the beliefs of young people with cerebral palsy and their families about sport and physical activity in relation to paediatric physiotherapy exercise

Background and Purpose Physiotherapy programmes are an important part of therapeutic input for young people with cerebral palsy (YPwCP), but adherence can be problematic. The involvement of physical activities (PA) could be a possible solution, but YPwCP have lower levels of physical leisure participation than their typically developing peers. Method This qualitative study aimed to explore the beliefs of young people with disabilities and their families about PA in relation to physiotherapy programmes. PA was broadly defined to include not only disability sports, but any aerobic exercise and ‘beliefs’ as perceptions, knowledge and attitudes. A purposive sample of participants from the researcher’s physiotherapy service was invited to undertake semi-structured interviews. Inclusion criteria were 8-19 years of age, having a disability, cognitively able and able to understand and express themselves in English. Parents/care givers were included to capture their discrete perspectives and enable reflective discussion about any synergies or differences between their beliefs and those of their children. Data was analysed using Interpretative Phenomenological Analysis (IPA). Results Two YPwCP and their mothers participated. Three main themes arose: • The feelings evoked by PA, in particular feelings of otherness were underpinned by the desire for ‘normal’ participatory experiences alongside typically developing peers. • External factors and others attitudes affect participation in PA, in particular unfavourable judgements and tokenism within mainstream environments contrasted with a normalising acceptance in disability sports settings. • Physiotherapy and PA are different, participants believed that physiotherapy, physiotherapists and medical venues possessed superior quality, legitimacy and potency. Conclusion The study revealed YPwCP and families’ unique beliefs and preferences concerning PA and the status of physiotherapy and physiotherapists within daily life. Physiotherapists should consider the influence of these beliefs when seeking to signpost to PA or enhance longer-term adherence to programmes within a context of reduced clinical contact

Single shot, temporally and spatially resolved measurements of fast electron dynamics using a chirped optical probe

A new approach to rear surface optical probing is presented that permits multiple, time-resolved 2D measurements to be made during a single, ultra-intense ( > 1018 W cm−2) laser-plasma interaction. The diagnostic is capable of resolving rapid changes in target reflectivity which can be used to infer valuable information on fast electron transport and plasma formation at the target rear surface. Initial results from the Astra-Gemini laser are presented, with rapid radial sheath expansion together with detailed filamentary features being observed to evolve during single shots

Understanding the enablers and barriers to implementing a patient-led escalation system: a qualitative study

Background: The management of acute deterioration following surgery remains highly variable. Patients and families can play an important role in identifying early signs of deterioration but effective contribution to escalation of care can be practically difficult to achieve. This paper reports the enablers and barriers to the implementation of patient-led escalation systems found during a process evaluation of a quality improvement programme Rescue for Emergency Surgery Patients Observed to uNdergo acute Deterioration (RESPOND). Methods: The research used ethnographic methods, including over 100 hours of observations on surgical units in three English hospitals in order to understand the everyday context of care. Observations focused on the coordination of activities such as handovers and how rescue featured as part of this. We also conducted 27 interviews with a range of clinical and managerial staff and patients. We employed a thematic analysis approach, combined with a theoretically focused implementation coding framework, based on Normalisation Process Theory. Results: We found that organisational infrastructural support in the form of a leadership support and clinical care outreach teams with capacity were enablers in implementing the patient-led escalation system. Barriers to implementation included making changes to professional practice without discussing the value and legitimacy of operationalising patient concerns, and ensuring equity of use. We found that organisational work is needed to overcome patient fears about disrupting social and cultural norms. Conclusions: This paper reveals the need for infrastructural support to facilitate the implementation of a patient-led escalation system, and leadership support to normalise the everyday process of involving patients and families in escalation. This type of system may not achieve its goals without properly understanding and addressing the concerns of both nurses and patients

Creative Heath in Communities:Supporting People to Live Well in West Yorkshire

Creating Change involves using a collaborative action inquiry approach working with stakeholder organisations and people with lived experience to explore how to evolve effective and meaningful creative health approaches across West Yorkshire. Rooted in stories from people with lived experience of community-based creative health approaches and the challenges encountered in practice by partner organisations, the project has co-generated in-depth learning about challenges and potential of sustaining creative health provision. Research team: Barry Percy-Smith, Rowan Bailey, Nic Stenberg, Claire Booth-Kurpnieks, Deborah Munt, David McQuillan, Liz Towns-Andrews. Contact Creating Change for further information: https://research.hud.ac.uk/institutes-centres/cacs/projects/creatingchang

Mathematical modelling of fibre-enhanced perfusion inside\ud a tissue-engineering bioreactor

We develop a simple mathematical model for forced flow of culture medium through a porous scaffold in a tissue- engineering bioreactor. Porous-walled hollow fibres penetrate the scaffold and act as additional sources of culture medium. The model, based on Darcy’s law, is used to examine the nutrient and shear-stress distributions throughout the scaffold. We consider several configurations of fibres and inlet and outlet pipes. Compared with a numerical solution of the full Navier–Stokes equations within the complex scaffold geometry, the modelling approach is cheap, and does not require knowledge of the detailed microstructure of the particular scaffold being used. The potential of this approach is demonstrated through quantification of the effect the additional flow from the fibres has on the nutrient and shear-stress distribution

Role of shear stress and tPA concentration in the fibrinolytic potential of thrombi

Funding: This research was funded by British Heart Foundation PG/08/127/26517 awarded to N.A.B. and D.E.N. C.S.W. and N.J.M. were supported by the British Heart Foundation project grants (PG/15/82/31721 and PG/20/17/35050). D.E.N. and A.J.L. were supported by the British Heart Foundation project grant PG/04/131/18118. D.E.N. is supported by the British Heart Foundation (CH/09/002, RE/18/5/34216, RG/16/10/32375) and is the recipient of a Wellcome Trust Senior Investigator Award (WT103782AIA).Peer reviewedPublisher PD

Fast electron transport patterns in intense laser-irradiated solids diagnosed by modeling measured multi-MeV proton beams

The measured spatial-intensity distribution of the beam of protons accelerated from the rear side of a solid target irradiated by an intense (>10 Wcm) laser pulse provides a diagnostic of the two-dimensional fast electron density profile at the target rear surface and thus the fast electron beam transport pattern within the target. An analytical model is developed, accounting for rear-surface fast electron sheath dynamics, ionization and projection of the resulting beam of protons. The sensitivity of the spatial-intensity distribution of the proton beam to the fast electron density distribution is investigated. An annular fast electron beam transport pattern with filamentary structure is inferred for the case of a thick diamond target irradiated at a peak laser intensity of 6 × 10 Wcm