63 research outputs found
Developing a group intervention to manage fatigue in rheumatoid arthritis through modifying physical activity
© 2019 The Author(s). Background: Fatigue is a major symptom of rheumatoid arthritis (RA). There is some evidence that physical activity (PA) may be effective in reducing RA fatigue. However, few PA interventions have been designed to manage fatigue and there is limited evidence of end-user input into intervention development. The aim of this research was to co-design an intervention to support self-management of RA fatigue through modifying PA. Methods: A series of studies used mixed methodological approaches to co-design a fatigue management intervention focused on modifying PA based on UK Medical Research Council guidance, and informed by the Behaviour Change Wheel theoretical framework. Development was based on existing evidence, preferences of RA patients and rheumatology healthcare professionals, and practical issues regarding intervention format, content and implementation. Results: The resulting group-based intervention consists of seven sessions delivered by a physiotherapist over 12 weeks. Each session includes an education and discussion session followed by supervised PA chosen by the participant. The intervention is designed to support modification and maintenance of PA as a means of managing fatigue. This is underpinned by evidence-based behaviour change techniques that might support changes in PA behaviour. Intervention delivery is interactive and aims to enhance capability, opportunity and motivation for PA. Conclusion: This study outlines stages in the systematic development of a theory-based intervention designed through consultation with RA patients and healthcare professionals to reduce the impact of RA fatigue. The feasibility of future evaluation of the intervention should now be determined
Implementing pelvic floor muscle training in women's childbearing years: A critical interpretive synthesis of individual, professional, and service issues
Antenatal pelvic floor muscle training (PFMT) may be effective for the prevention and treatment of urinary and fecal incontinence both in pregnancy and postnatally, but it is not routinely implemented in practice despite guideline recommendations. This review synthesizes evidence that exposes challenges, opportunities, and concerns regarding the implementation of PFMT during the childbearing years, from the perspective of individuals, healthcare professionals (HCPs), and organizations.MethodsCritical interpretive synthesis of systematically identified primary quantitative or qualitative studies or research syntheses of women's and HCPs attitudes, beliefs, or experiences of implementing PFMT.ResultsFifty sources were included. These focused on experiences of postnatal urinary incontinence (UI) and perspectives of individual postnatal women, with limited evidence exploring the views of antenatal women and HCP or wider organizational and environmental issues. The concept of agency (people's ability to effect change through their interaction with other people, processes, and systems) provides an over?arching explanation of how PFMT can be implemented during childbearing years. This requires both individual and collective action of women, HCPs, maternity services and organizations, funders and policymakers.ConclusionNumerous factors constrain women's and HCPs capacity to implement PFMT. It is unrealistic to expect women and HCPs to implement PFMT without reforming policy and service delivery. The implementation of PFMT during pregnancy, as recommended by antenatal care and UI management guidelines, requires policymakers, organizations, HCPs, and women to value the prevention of incontinence throughout women's lives by using low?risk, low?cost, and proven strategies as part of women's reproductive health
Moving through Motherhood:Involving the Public in Research to Inform Physical Activity Promotion throughout Pregnancy and Beyond
open access articleInformation received by women regarding physical activity during and after pregnancy often lacks clarity and may be conflicting and confusing. Without clear, engaging, accessible guidance centred on the experiences of pregnancy and parenting, the benefits of physical activity can be lost. We describe a collaborative process to inform the design of evidence-based, user-centred physical activity resources which reflect diverse experiences of pregnancy and early parenthood. Two iterative, collaborative phases involving patient and public involvement (PPI) workshops, a scoping survey (n = 553) and stakeholder events engaged women and maternity, policy and physical activity stakeholders to inform pilot resource development. These activities shaped understanding of challenges experienced by maternity and physical activity service providers, pregnant women and new mothers in relation to supporting physical activity. Working collaboratively with women and stakeholders, we co-designed pilot resources and identified important considerations for future resource development. Outcomes and lessons learned from this process will inform further work to support physical activity during pregnancy and beyond, but also wider health research where such collaborative approaches are important. We hope that drawing on our experiences and sharing outcomes from this work provide useful information for researchers, healthcare professionals, policy makers and those involved in supporting physical activity behaviour
RELICS: High-Resolution Constraints on the Inner Mass Distribution of the z=0.83 Merging Cluster RXJ0152.7-1357 from strong lensing
Strong gravitational lensing (SL) is a powerful means to map the distribution
of dark matter. In this work, we perform a SL analysis of the prominent X-ray
cluster RXJ0152.7-1357 (z=0.83, also known as CL 0152.7-1357) in \textit{Hubble
Space Telescope} images, taken in the framework of the Reionization Lensing
Cluster Survey (RELICS). On top of a previously known galaxy multiply
imaged by RXJ0152.7-1357, for which we identify an additional multiple image,
guided by a light-traces-mass approach we identify seven new sets of multiply
imaged background sources lensed by this cluster, spanning the redshift range
[1.79-3.93]. A total of 25 multiple images are seen over a small area of ~0.4
, allowing us to put relatively high-resolution constraints on the
inner matter distribution. Although modestly massive, the high degree of
substructure together with its very elongated shape make RXJ0152.7-1357 a very
efficient lens for its size. This cluster also comprises the third-largest
sample of z~6-7 candidates in the RELICS survey. Finally, we present a
comparison of our resulting mass distribution and magnification estimates with
those from a Lenstool model. These models are made publicly available through
the MAST archive.Comment: 15 Pages, 7 Figures, 4 Tables Accepted for publication in Ap
Moving through Motherhood: Involving the Public in Research to Inform Physical Activity Promotion throughout Pregnancy and Beyond.
Information received by women regarding physical activity during and after pregnancy often lacks clarity and may be conflicting and confusing. Without clear, engaging, accessible guidance centred on the experiences of pregnancy and parenting, the benefits of physical activity can be lost. We describe a collaborative process to inform the design of evidence-based, user-centred physical activity resources which reflect diverse experiences of pregnancy and early parenthood. Two iterative, collaborative phases involving patient and public involvement (PPI) workshops, a scoping survey (n = 553) and stakeholder events engaged women and maternity, policy and physical activity stakeholders to inform pilot resource development. These activities shaped understanding of challenges experienced by maternity and physical activity service providers, pregnant women and new mothers in relation to supporting physical activity. Working collaboratively with women and stakeholders, we co-designed pilot resources and identified important considerations for future resource development. Outcomes and lessons learned from this process will inform further work to support physical activity during pregnancy and beyond, but also wider health research where such collaborative approaches are important. We hope that drawing on our experiences and sharing outcomes from this work provide useful information for researchers, healthcare professionals, policy makers and those involved in supporting physical activity behaviour
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Parental experiences of supporting children with clinically significant post-traumatic distress: a qualitative study of families accessing psychological services
The aim of this study was to investigate the experiences of parents in providing support to their child following trauma exposure in cases where children are experiencing clinically significant levels of post-traumatic distress. Qualitative interviews were conducted with parents whose child was exposed to a trauma and referred for psychological treatment. Parents reported considerable anxiety in coping with their childâs post-traumatic distress. Avoidance of trauma-related discussions was encouraged due to concerns that non-avoidant approaches may worsen childrenâs post-trauma difficulties. Nonetheless, parents were often sensitive to their childâs distress and offered reassurance and other forms of support. Many barriers existed to accessing psychological treatment, and perceptions of inadequate guidance from therapists on supporting child adjustment contributed to parental distress. The results illustrate the strategies used by parents in supporting their child post-trauma and may assist mental health professionals in providing acceptable guidance to parents following child trauma
RELICS: A Very Large () Cluster Lens -- RXC J0032.1+1808
Extensive surveys with the \textit{Hubble Space Telescope} (HST) over the
past decade, targeting some of the most massive clusters in the sky, have
uncovered dozens of galaxy-cluster strong lenses. The massive cluster
strong-lens scale is typically \theta_{E}\sim10\arcsec to \sim30-35\arcsec,
with only a handful of clusters known with Einstein radii
\theta_{E}\sim40\arcsec or above (for , nominally). Here we
report another very large cluster lens, RXC J0032.1+1808 (), the
second richest cluster in the redMapper cluster catalog and the 85th most
massive cluster in the Planck Sunyaev-Zel'dovich catalog. With our
Light-Traces-Mass and fully parametric (dPIEeNFW) approaches, we construct
strong lensing models based on 18 multiple images of 5 background galaxies
newly identified in the \textit{Hubble} data mainly from the
\textit{Reionization Lensing Cluster Survey} (RELICS), in addition to a known
sextuply imaged system in this cluster. Furthermore, we compare these models to
Lenstool and GLAFIC models that were produced independently as part of the
RELICS program. All models reveal a large effective Einstein radius of
\theta_{E}\simeq40\arcsec (), owing to the obvious
concentration of substructures near the cluster center. Although RXC
J0032.1+1808 has a very large critical area and high lensing strength, only
three magnified high-redshift candidates are found within the field targeted by
RELICS. Nevertheless, we expect many more high-redshift candidates will be seen
in wider and deeper observations with \textit{Hubble} or \emph{JWST}. Finally,
the comparison between several algorithms demonstrates that the total error
budget is largely dominated by systematic uncertainties.Comment: 23 pages, accepted for publication in Ap
RELICS: Strong Lensing analysis of the galaxy clusters Abell S295, Abell 697, MACS J0025.4-1222, and MACS J0159.8-0849
We present a strong-lensing analysis of four massive galaxy clusters imaged
with the Hubble Space Telescope in the Reionization Lensing Cluster Survey. We
use a Light-Traces-Mass technique to uncover sets of multiply images and
constrain the mass distribution of the clusters. These mass models are the
first published for Abell S295 and MACS J0159.8-0849, and are improvements over
previous models for Abell 697 and MACS J0025.4-1222. Our analysis for MACS
J0025.4-1222 and Abell S295 shows a bimodal mass distribution supporting the
merger scenarios proposed for these clusters. The updated model for MACS
J0025.4-1222 suggests a substantially smaller critical area than previously
estimated. For MACS J0159.8-0849 and Abell 697 we find a single peak and
relatively regular morphology, revealing fairly relaxed clusters. Despite being
less prominent lenses, three of these clusters seem to have lensing strengths,
i.e. cumulative area above certain magnification, similar to the Hubble
Frontier Fields clusters (e.g., A() arcmin, A()
arcmin), which in part can be attributed to their merging
configurations. We make our lens models publicly available through the Mikulski
Archive for Space Telescopes. Finally, using Gemini-N/GMOS spectroscopic
observations we detect a single emission line from a high-redshift
galaxy candidate lensed by Abell 697. While we cannot rule
out a lower-redshift solution, we interpret the line as Ly at
, in agreement with its photometric redshift and dropout
nature. Within this scenario we measure a Ly rest-frame equivalent
width of \AA, and an observed Gaussian width of km/s.Comment: 23 pages, 16 figures; V2, accepted for publication in Ap
Complete Set of Elastic Moduli of a Spin-Crossover Solid: Spin-State Dependence and Mechanical Actuation
Molecular spin crossover complexes are promising candidates for mechanical actuation purposes. The relationships between their crystal structure and mechanical properties remain, however, not well understood. In this study, combining high pressure synchrotron Xray diffraction and nuclear inelastic scattering measurements, we assessed the effective macroscopic bulk modulus (11.5 ± 2.0 GPa), Youngâs modulus (10.9 ± 1.0 GPa) and Poissonâs ratio (0.34 ± 0.04) of the spin crossover complex [FeII(HB(tz)3)2] (tz = 1,2,4-triazol-1-yl) in its low spin state. Crystal structure analysis revealed a pronounced anisotropy of the lattice compressibility, which was correlated with the difference in spacing between the molecules in different crystallographic directions. Switching the molecules from the low spin to the high spin state leads to a remarkable drop of the Youngâs modulus to 7.1 ± 0.5 GPa, which was also assessed in thin film samples by means of micromechanical measurements. These results are in agreement with the high cooperativity of the spin crossover in this compound and highlight its application potential in terms of recoverable stress (21 ± 1 MPa) and work density (15 ± 6 mJ/cm3)
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