Youth experience matters: participation in physical activity by young people with physical disability. A protocol for a national participation snapshot and Delphi consensus study

Data availability: Underlying data: No underlying data are associated with this article. Extended data: Figshare: Youth Experience Matters: Parent Information Leaflet https://doi.org/10.6084/m9.figshare.23278283.v1 This project contains the following extended data: AD6791_YEM_Parent_A5Booklet_V6.pdf Figshare: Youth Experience Matters: Young Person Information Leaflet https://doi.org/10.6084/m9.figshare.23278316.v1 This project contains the following extended data: AD6791_YEM_YoungPerson_A5Booklet_V3.pdf Figshare: Youth Experience Matters: Promotional material https://doi.org/10.6084/m9.figshare.23278370.v1 This project contains the following extended data: AD6791_YEM_Pull-Up-V1.pdf Figshare: Youth Experience Matters: Round 1 survey (Parts 1 and 2) - for information only (not for completion by participants.) https://doi.org/10.6084/m9.figshare.23280209.v1 This project contains the following extended data: YEM_SurveyR1_reproduced.pdf Figshare: Youth Experience Matters Data Management Plan 02 May 2023 https://doi.org/10.6084/m9.figshare.23277638.v1 This project contains the following extended data: HRCI-HRB-2022-006_Youth_Experience_Matters-DMP_v1.2_02May2023.pdf Data are available under the terms of the Creative Commons Attribution 4.0 International license (CC-BY 4.0).Copyright: © 2023 Brady K et al. Young people with physical disability experience challenges to being physically active. To attain the health benefits of physical activity (PA) and sustain engagement, it is essential that participation is meaningful and enjoyable. This study aims to understand “what really matters” for participating in PA, from the perspectives of adolescents with physical disability. A parallel convergent mixed methods study will be undertaken, comprising a national cross-sectional quantitative assessment of PA participation (“Participation Snapshot”) and Delphi consensus study (“Delphi”). Young people (n=100) aged 13-17 years with a primary physical disability diagnosis will be invited to take part. The Participation Snapshot primary outcome is the Children’s Assessment of Participation and Enjoyment (CAPE). Contextual factors including disability diagnosis, demographics, mobility (Functional Mobility Scale), hand function (Manual Ability Classification System) and health related quality of life (Child Health Utility 9D) will also be collected. The Delphi will comprise two to four survey rounds, until consensus is reached. Round 1 (“Your Experience”) consists of a bespoke survey, designed and piloted with a public and patient involvement (PPI) panel, with open-ended questions and Likert scales inviting contributions from young people on their prior experience, barriers and facilitators, and ideas on participation in PA. Responses will be analysed using reflexive thematic analysis to construct the key themes, conceptualized under the “F-words” framework of the International Classification of Functioning, Disability and Health (ICF). These themes will be presented back to participants in subsequent rounds for selection and ranking, until consensus is achieved on the “top 10 priorities”. The project team and PPI panel will then co-design dissemination material and identify targets for dissemination to relevant stakeholder or policy groups. The findings will provide a basis for developing interventions aiming to empower, encourage and sustain future physical activity participation in a meaningful way by young people with physical disability.Health Research Board Ireland (HRCI-JFS-2022-006) via the Health Research Charities Ireland / Health Research Board Joint Funding Scheme 2022

Isolated right ventricular failure in hyperthyroidism: a clinical dilemma

We present a unique case of a 42-year-old gentleman with newly diagnosed Graves’ disease and isolated right ventricular failure. Extensive evaluation to include echocardiogram and cardiac catheterization were negative for significant pulmonary hypertension or coronary artery disease as potential etiologies. Hyperthyroid induced vasospasm is a rare but reported clinical entity that serves to be a clinical and diagnostic dilemma

Communication style and exercise compliance in physiotherapy (CONNECT). A cluster randomized controlled trial to test a theory-based intervention to increase chronic low back pain patients’ adherence to physiotherapists’ recommendations: study rationale, design, and methods

Physical activity and exercise therapy are among the accepted clinical rehabilitation guidelines and are recommended self-management strategies for chronic low back pain. However, many back pain sufferers do not adhere to their physiotherapist’s recommendations. Poor patient adherence may decrease the effectiveness of advice and home-based rehabilitation exercises. According to self-determination theory, support from health care practitioners can promote patients’ autonomous motivation and greater long-term behavioral persistence (e.g., adherence to physiotherapists’ recommendations). The aim of this trial is to assess the effect of an intervention designed to increase physiotherapists’ autonomy-supportive communication on low back pain patients’ adherence to physical activity and exercise therapy recommendations. \ud \ud This study will be a single-blinded cluster randomized controlled trial. Outpatient physiotherapy centers (N =12) in Dublin, Ireland (population = 1.25 million) will be randomly assigned using a computer-generated algorithm to either the experimental or control arm. Physiotherapists in the experimental arm (two hospitals and four primary care clinics) will attend eight hours of communication skills training. Training will include handouts, workbooks, video examples, role-play, and discussion designed to teach physiotherapists how to communicate in a manner that promotes autonomous patient motivation. Physiotherapists in the waitlist control arm (two hospitals and four primary care clinics) will not receive this training. Participants (N = 292) with chronic low back pain will complete assessments at baseline, as well as 1 week, 4 weeks, 12 weeks, and 24 weeks after their first physiotherapy appointment. Primary outcomes will include adherence to physiotherapy recommendations, as well as low back pain, function, and well-being. Participants will be blinded to treatment allocation, as they will not be told if their physiotherapist has received the communication skills training. Outcome assessors will also be blinded. \ud \ud We will use linear mixed modeling to test between arm differences both in the mean levels and the rates of change of the outcome variables. We will employ structural equation modeling to examine the process of change, including hypothesized mediation effects. \ud \ud This trial will be the first to test the effect of a self-determination theory-based communication skills training program for physiotherapists on their low back pain patients’ adherence to rehabilitation recommendations. Current Controlled Trials ISRCTN63723433\u

Record of forearc devolatilization in low-T, high-P/T metasedimentary suites: Significance for models of convergent margin chemical cycling

[1] The Franciscan Complex (Coast Ranges and Diablo Range, California) and the Western Baja Terrane (WBT; Baja California, Mexico) were metamorphosed along high-P/T paths like those experienced in many active subduction zones, recording peak conditions up to ∼1 GPa and 300°C. Franciscan and WBT metasedimentary rocks are similar in lithology and geochemistry to clastic sediments outboard of many subduction zones. These metamorphic suites provide evidence regarding devolatilization history experienced by subducting sediments, information that is needed to mass-balance the inputs of materials into subduction zones with their respective outputs. Analyzed samples have lower total volatile contents than their likely protoliths. Little variation in LOI among similar lithologies at differing metamorphic grades, suggests that loss of structurally bound water occurred during early clay-mineral transformations. Finely disseminated carbonate is present in the lowest-grade rocks, but absent in all higher-grade rocks. δ13CVPDB of reduced-C is uniform in the lower-grade Franciscan samples (mean = −25.1‰, 1σ = 0.4‰), but varies in higher-grade rocks (−28.8 to −21.9‰). This likely reflects a combination of devolatilization and C-isotope exchange, between organic and carbonate reservoirs. Nitrogen concentration ranges from 102 to 891 ppm, with δ15Nair of +0.1 to +3.0‰ (n = 35); this organic-like δ15N probably represents an efficient transfer of N from decaying organic matter to reacting clay minerals. The lowest-grade rocks in the Coastal Belt have elevated carbonate contents and correlated N-δ15N variations, and exhibit the most uniform δ13C and C/N, all consistent with these rocks having experienced less devolatilization. Most fluid-mobile trace elements are present at concentrations indistinguishable from protoliths. Suggesting that, despite apparent loss of much clay-bound H2O and CO2 from diagenetic cements (combined, <5–10 wt. %), most fluid-mobile trace elements are retained to depths of up to ∼40 km. Organic-like δ15N, lower than that of many seafloor sediments, is consistent with some loss of adsorbed N (perhaps as NO3−) during early stages of diagenesis. The efficient entrainment of fluid-mobile elements to depths of at least 40 km in these relatively cool subduction zone settings lends credence to models invoking transfer of these elements to the subarc mantle

A walking programme and a supervised exercise class versus usual physiotherapy for chronic low back pain: a single-blinded randomised controlled trial. (The Supervised Walking In comparison to Fitness Training for Back Pain (SWIFT) Trial)

BACKGROUND: Chronic low back pain (CLBP) is a persistent disabling condition with rising significant healthcare, social and economic costs. Current research supports the use of exercise-based treatment approaches that encourage people with CLBP to assume a physically active role in their recovery. While international clinical guidelines and systematic reviews for CLBP support supervised group exercise as an attractive first-line option for treating large numbers of CLBP patients at low cost, barriers to their delivery include space and time restrictions in healthcare settings and poor patient attendance. The European Clinical Guidelines have identified the need for research in the use of brief/minimal contact self-activation interventions that encourage participation in physical activity for CLBP. Walking may be an ideally suited form of individualized exercise prescription as it is easy to do, requires no special skills or facilities, and is achievable by virtually all ages with little risk of injury, but its effectiveness for LBP is unproven. METHODS AND DESIGN: This study will be an assessor-blinded randomized controlled trial that will investigate the difference in clinical effectiveness and costs of an individualized walking programme and a supervised general exercise programme compared to usual physiotherapy, which will act as the control group, in people with chronic low back pain. A sample of 246 patients will be recruited in Dublin, Ireland through acute general hospital outpatient physiotherapy departments that provide treatment for people with CLBP. Patients will be randomly allocated to one of the three groups in a concealed manner. The main outcomes will be functional disability, pain, quality of life, fear avoidance, back beliefs, physical activity, satisfaction and costs, which will be evaluated at baseline, and 3, 6 and 12 months [follow-up by pre-paid postage]. Qualitative telephone interviews and focus groups will be embedded in the research design to obtain feedback about participants' experiences of the interventions and trial participation, and to inform interpretation of the quantitative data. Planned analysis will be by intention to treat (quantitative data) and thematic analysis (qualitative data) DISCUSSION: The trial will evaluate the effectiveness of a walking programme and a supervised general exercise programme compared to usual physiotherapy in people with CLBP. TRIAL REGISTRATION: Current controlled trial ISRCTN1759209

Exercise and manual auricular acupuncture: a pilot assessor-blind randomised controlled trial. (The acupuncture and personalised exercise programme (APEP) Trial)

<p>Abstract</p> <p>Background</p> <p>Evidence supports the use of exercise for chronic low back pain (CLBP); however, adherence is often poor due to ongoing pain. Auricular acupuncture is a form of pain relief involving the stimulation of points on the outer ear corresponding with specific body parts. It may be a useful adjunct to exercise in managing CLBP; however, there is only limited evidence to support its use with this patient group.</p> <p>Methods/Design</p> <p>This study was designed to test the feasibility of an assessor-blind randomised controlled trial which assess the effects on clinical outcomes and exercise adherence of adding manual auricular acupuncture to a personalised and supervised exercise programme (PEP) for CLBP. No sample size calculation has been carried out as this study aims to identify CLBP referral rates within the catchment area of the study site. The researchers aim to recruit four cohorts of n = 20 participants to facilitate a power analysis for a future randomised controlled trial. A computer generated random allocation sequence will be prepared centrally and used to allocate participants by cohort to one of the following interventions: 1) six weeks of PEP <it>plus </it>manual auricular acupuncture; 2) six weeks of PEP alone. Both groups will also complete a further six weeks of self-paced exercise with telephone follow-up support. In addition to a baseline and exit questionnaire at the beginning and end of the study, the following outcomes will be collected at baseline, and after 7, 13 and 25 weeks: pain frequency and bothersomeness, back-specific function, objective assessment and recall of physical activity, use of analgesia, perceived self-efficacy, fear avoidance beliefs, and beliefs about the consequences of back pain. Since this is a feasibility study, significance tests will not be presented, and treatment effects will be represented by point estimates and confidence intervals. For each outcome variable, analysis of covariance will be performed on the data, conditioning on the baseline value.</p> <p>Discussion</p> <p>The results of this study investigating the adjuvant effects of auricular acupuncture to exercise in managing CLBP will be used to inform the design of a future multi-centre randomised controlled trial.</p> <p>Trial Registration</p> <p>Current Controlled Trials ISRCTN94142364.</p

The Back 2 Activity Trial: education and advice versus education and advice plus a structured walking programme for chronic low back pain

<p>Abstract</p> <p>Background</p> <p>Current evidence supports the use of exercise-based treatment for chronic low back pain that encourages the patient to assume an active role in their recovery. Walking has been shown it to be an acceptable type of exercise with a low risk of injury. However, it is not known whether structured physical activity programmes are any more effective than giving advice to remain active.</p> <p>Methods/Design</p> <p>The proposed study will test the feasibility of using a pedometer-driven walking programme, as an adjunct to a standard education and advice session in participants with chronic low back pain. Fifty adult participants will be recruited via a number of different sources. Baseline outcome measures including self reported function; objective physical activity levels; fear-avoidance beliefs and health-related quality of life will be recorded. Eligible participants will be randomly allocated under strict, double blind conditions to one of two treatments groups. Participants in group A will receive a single education and advice session with a physiotherapist based on the content of the 'Back Book'. Participants in group B will receive the same education and advice session. In addition, they will also receive a graded pedometer-driven walking programme prescribed by the physiotherapist. Follow up outcomes will be recorded by the same researcher, who will remain blinded to group allocation, at eight weeks and six months post randomisation. A qualitative exploration of participants' perception of walking will also be examined by use of focus groups at the end of the intervention. As a feasibility study, treatment effects will be represented by point estimates and confidence intervals. The assessment of participant satisfaction will be tabulated, as will adherence levels and any recorded difficulties or adverse events experienced by the participants or therapists. This information will be used to modify the planned interventions to be used in a larger randomised controlled trial.</p> <p>Discussion</p> <p>This paper describes the rationale and design of a study which will test the feasibility of using a structured, pedometer-driven walking programme in participants with chronic low back pain.</p> <p>Trial Registration</p> <p>[ISRCTN67030896]</p

Measuring psychological need states in sport: Theoretical considerations and a new measure

© 2019 Elsevier Ltd Objectives: Research guided by Self-determination Theory (Deci & Ryan, 1985; Ryan & Deci, 2017) has repeatedly demonstrated the importance of focusing on both the bright (satisfaction) and dark (frustration) sides of the three basic psychological needs. Recently, researchers have also argued for the utility of assessing a third need state, that of “unfulfillment”. In this paper, we outline an effort to develop and provide initial validity evidence for scores of a new multidimensional and sport-specific measure, the Psychological Need States in Sport-Scale (PNSS-S), to assess the satisfaction, frustration, and unfulfillment of all three needs. Method: In Study 1, we developed 46 candidate items, and tested evidence for the factorial structure of the responses to the newly developed items, internal consistency and discriminant validity of the subscale scores. Following refinement, the replication of the favored model was tested using an independent sample of athletes in Study 2. Evidence for the nomological network of the subscales of the new measure was also demonstrated in Study 2. Results: Factor models incorporating all three need states showed poor fit with the data. However, following post-hoc modifications, a six-factor model assessing the need states of satisfaction and frustration, separately for autonomy, competence, and relatedness, was found to have good fit to the data. After refinement, the 29-item six-factor model was found to demonstrate good fit, good standardized factor loadings, factor correlations in the expected directions, and acceptable estimates of internal consistency in Study 2. Tests of nomological networks showed that the six need states were significantly predicted by contextual autonomy, competence, and relatedness support/thwarts as expected. Autonomy and competence need satisfaction were significantly associated with engagement; and competence and relatedness need satisfaction were significantly associated with positive affect. In addition, autonomy and competence need frustration were significantly associated with exhaustion and all three need frustration states significantly predicted negative affect. Conclusions: A tripartite conceptualization of the need states was not empirically supported. Nevertheless, the PNSS-S makes a unique contribution to the sport literature, as it represents the first sport-specific measure of six distinct, yet, correlated states of the satisfaction and frustration of autonomy, competence, and relatedness needs