“…like you’re pushing the snowball back up hill”—the experiences of Australian physiotherapists promoting non-treatment physical activity: A qualitative study

Participating in physical activity is important for maintaining general health. When physiotherapists promote physical activity for the purposes of maintaining or improving a patient‟s general health, they are promoting non-treatment physical activity. Physiotherapists have a responsibility to promote non-treatment physical activity to their patients while also providing the patient with treatment for their presenting complaint. This qualitative study explored the experiences of Australian physiotherapists promoting non-treatment physical activity to patients with musculoskeletal conditions. Ten Australian physiotherapists treating patients with musculoskeletal conditions in private practice and outpatient settings were recruited using a social media campaign and snowballing. All interviewees received one $AU20 gift card for participating. Sixty-minute semi-structured interviews were conducted and were transcribed verbatim. Interpretative phenomenological analysis was used to design the interview guide and analyse data. Transcripts were used to identify emergent and superordinate themes. Most interviewees were female, aged between 25–34 years, physically active and reported promoting NTPA. The superordinate themes that emerged from the transcripts included: Internal and external influences on NTPA promotion, approach taken by the physiotherapist towards NTPA promotion, challenges experienced when promoting NTPA, and skills and training. In conclusion, physiotherapists reported they were well-placed to promote NTPA, but they face many challenges. The perceived inability to motivate patients to become physically active and the need to prioritise patient expectations of hands-on therapy made NTPA promotion difficult. Workplace specific factors, such as having an open-plan clinic environment and having other staff who promote NTPA, were perceived to make NTPA promotion easier. Using effective marketing strategies that portray the physiotherapy clinic as a physically active environment might see patients expect NTPA promotion, making NTPA promotion easier for Australian physiotherapists in the future

Geospatial Resolution of Human and Bacterial Diversity with City-Scale Metagenomics

The panoply of microorganisms and other species present in our environment influence human health and disease, especially in cities, but have not been profiled with metagenomics at a city-wide scale. We sequenced DNA from surfaces across the entire New York City (NYC) subway system, the Gowanus Canal, and public parks. Nearly half of the DNA (48%) does not match any known organism; identified organisms spanned 1,688 bacterial, viral, archaeal, and eukaryotic taxa, which were enriched for harmless genera associated with skin (e.g., Acinetobacter). Predicted ancestry of human DNA left on subway surfaces can recapitulate U.S. Census demographic data, and bacterial signatures can reveal a station’s history, such as marine-associated bacteria in a hurricane-flooded station. Some evidence of pathogens was found (Bacillus anthracis), but a lack of reported cases in NYC suggests that the pathogens represent a normal, urban microbiome. This baseline metagenomic map of NYC could help long-term disease surveillance, bioterrorism threat mitigation, and health management in the built environment of citie

Plant Species\u27 Origin Predicts Dominance and Response to Nutrient Enrichment and Herbivores in Global Grasslands

Exotic species dominate many communities; however the functional significance of species\u27 biogeographic origin remains highly contentious. This debate is fuelled in part by the lack of globally replicated, systematic data assessing the relationship between species provenance, function and response to perturbations. We examined the abundance of native and exotic plant species at 64 grasslands in 13 countries, and at a subset of the sites we experimentally tested native and exotic species responses to two fundamental drivers of invasion, mineral nutrient supplies and vertebrate herbivory. Exotic species are six times more likely to dominate communities than native species. Furthermore, while experimental nutrient addition increases the cover and richness of exotic species, nutrients decrease native diversity and cover. Native and exotic species also differ in their response to vertebrate consumer exclusion. These results suggest that species origin has functional significance, and that eutrophication will lead to increased exotic dominance in grasslands

What\u27s new in ... capnography monitoring for dental conscious sedation: a clinical review

Capnography monitoring during conscious sedation is not currently required for dentistry in Britain and Ireland. Other countries have introduced guidelines and standards requiring capnography monitoring for procedural sedation. This review highlights the variability of procedural sedation including the setting, the position on the sedation continuum, and the routine use of supplemental oxygen. Specific research is required for conscious sedation in a dental setting to support standards and guidelines with regard to capnography monitoring

The behaviour change techniques used by Australian physiotherapists to promote non-treatment physical activity to patients with musculoskeletal conditions

OBJECTIVES: To determine: (i) the behaviour change techniques used by a sample of Australian physiotherapists to promote non-treatment physical activity; and (ii) whether those behaviour change techniques are different to the techniques used to encourage adherence to rehabilitation exercises. DESIGN: Cross-sectional survey. METHOD: An online self-report survey was advertised to private practice and outpatient physiotherapists treating patients with musculoskeletal conditions. The use of 50 behaviour change techniques were measured using five-point Likert-type scale questions. RESULTS: Four-hundred and eighty-six physiotherapists responded to the survey, with 216 surveys fully completed. Most respondents (85.1%) promoted non-treatment physical activity often or all of the time. Respondents frequently used 29 behaviour change techniques to promote non-treatment physical activity or encourage adherence to rehabilitation exercises. A similar number of behaviour change techniques was frequently used to encourage adherence to rehabilitation exercises (n=28) and promote non-treatment physical activity (n=26). Half of the behaviour change techniques included in the survey were frequently used for both promoting non-treatment physical activity and encouraging adherence to rehabilitation exercises (n=25). Graded tasks was the most, and punishment was the least, frequently reported technique used to promote non-treatment physical activity and encourage adherence to rehabilitation exercises. CONCLUSIONS: Respondents reported using similar behaviour change techniques to promote non-treatment physical activity and encourage adherence to rehabilitation exercises. The variability in behaviour change technique use suggests the behaviour the physiotherapist is promoting influences their behaviour change technique choice. Including the frequently-used behaviour change techniques in non-treatment physical activity promotion interventions might improve their efficacy

The self-reported factors that influence Australian physiotherapists\u27 choice to promote non-treatment physical activity to patients with musculoskeletal conditions

OBJECTIVES: To determine the factors that influence physiotherapists\u27 choice to promote non-treatment physical activity to patients with musculoskeletal conditions. DESIGN: Cross sectional survey. METHODS: A national, online self report survey was targeted at Australian registered physiotherapists primarily treating patients with musculoskeletal conditions in private practice and outpatient settings. Likert scale questions were used to measure the factors influencing non-treatment physical activity promotion by physiotherapists. RESULTS: Two hundred and sixteen full responses were received. Most (56.6%) respondents irregularly promoted non-treatment physical activity, whereas 43.4% always promoted non-treatment physical activity. Promotion of non-treatment physical activity was bivariately associated with respondents\u27 own physical activity level (x CONCLUSIONS: The majority of surveyed Australian physiotherapists irregularly promoted non-treatment physical activity. Lack of knowledge of how to promote non-treatment physical activity, prioritising other patient problems before non-treatment physical activity promotion and using promotion methods that are not compatible with current practice might reduce non-treatment physical activity promotion frequency by physiotherapists