The Individual Recovery Outcomes Counter:preliminary validation of a personal recovery measure

Aims and methodThe Individual Recovery Outcomes Counter (I.ROC) is to date the only recovery outcomes instrument developed in Scotland. This paper describes the steps taken to initially assess its validity and reliability, including factorial analysis, internal consistency and a correlation benchmarking analysis.ResultsThe I.ROC tool showed high internal consistency. Exploratory factor analysis indicated a two-factor structure comprising intrapersonal recovery (factor 1) and interpersonal recovery (factor 2), explaining between them over 50% of the variance in I.ROC scores. There were no redundant items and all loaded on at least one of the factors. The I.ROC significantly correlated with widely used existing instruments assessing both personal recovery and clinical outcomes.Clinical implicationsI.ROC is a valid and reliable measure of recovery in mental health, preferred by service users when compared with well-established instruments. It could be used in clinical settings to map individual recovery, providing feedback for service users and helping to assess service outcomes.</p

Factor validation and Rasch analysis of the individual recovery outcomes counter

Objective: The Individual Recovery Outcomes Counter is a 12-item personal recovery self assessment tool for adults with mental health problems. Although widely used across Scotland, limited research into its psychometric properties has been conducted. We tested its' measurement properties to ascertain the suitability of the tool for continued use in its present form.Materials and methods: Anonymised data from the assessments of 1,743 adults using mental health services in Scotland were subject to tests based on principles of Rasch measurement theory, principal components analysis and confirmatory factor analysis.Results: Rasch analysis revealed that the 6-point response structure of the Individual Recovery Outcomes Counter was problematic. Re-scoring on a 4-point scale revealed well ordered items that measure a single, recovery-related construct, and has acceptable fit statistics. Confirmatory factor analysis supported this. Scale items covered around 75% of the recovery continuum; those individuals least far along the continuum were least well addressed.Conclusions: A modified tool worked well for many, but not all, service users. The study suggests specific developments are required if the Individual Recovery Outcomes Counter is to maximise its' utility for service users and provide meaningful data for service providers.*Implications for Rehabilitation*Agencies and services working with people with mental health problems aim to help them with their recovery.*The individual recovery outcomes counter has been developed and is used widely in Scotland to help service users track their progress to recovery.*Using a large sample of routinely collected data we have demonstrated that a number of modifications are needed if the tool is to adequately measure recovery.*This will involve consideration of the scoring system, item content and inclusion, and theoretical basis of the tool

Optical, magnetic resonance, and ENDOR studies of the nπ^* triplet state of benzophenone in mixed crystals

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New Genus and Species of Aporocotylidae (Digenea) from a Basal Actinopterygian, the American Paddlefish, Polyodon spathula, (Acipenseriformes: Polyodontidae) from the Mississippi Delta

Acipensericola petersoni n. gen., n. sp. (Digenea: Aporocotylidae) infects the heart of the American paddlefish Polyodon spathula (Walbaum, 1792) in the Mississippi Delta. It has robust, spike-like body spines arranged in ventrolateral transverse rows; a bowl-shaped anterior sucker centered on the mouth and having minute spines on the inner anteroventral surface only; a pharynx; an inverse U-shaped ceca extending to near the posterior body end; intercecal testes comprising a pre-ovarian testicular column plus a single testis posteriorly; an extensively lobed ovary located medially and immediately posterior to the testicular column; a spherical ootype that is intercecal and post-ovarian; a Laurer’s canal; and a common genital pore. The new species is the first-named aporocotylid collected from a basal actinopterygian. It resembles the chondrichthyan aporocotylids Chimaerohemecus trondheimensis, Orchispirium heterovitellatum, and Hyperandrotrema cetorhini in having an inverse U-shaped ceca, but it is morphologically most similar to the anguilliform aporocotylid Paracardicoloides yamagutii in having that feature plus a comparable anterior sucker, a single testis posteriorly, an intertesticular ovary, and a common genital pore. Sequence data for the complete small subunit ribosomal DNA (18S) do not refute its membership within Aporocotylidae nor its affinity to 1 of those aforementioned aporocotylids: A. petersoni was basal to the few teleost aporocotylids analyzed, and C. trondheimensis was the only taxon basal to A. petersoni. We regard the specimens of Spirorchis sp. previously reported from the shortnose sturgeon Acipenser brevirostrum Lesueur, 1818 as congeneric with the new species

Quantitative sensory testing in children with sickle cell disease: additional insights and future possibilities.

Quantitative sensory testing (QST) is used in a variety of pain disorders to characterize pain and predict prognosis and response to specific therapies. In this study, we aimed to confirm results in the literature documenting altered QST thresholds in sickle cell disease (SCD) and assess the test-retest reliability of results over time. Fifty-seven SCD and 60 control subjects aged 8-20 years underwent heat and cold detection and pain threshold testing using a Medoc TSAII. Participants were tested at baseline and 3 months; SCD subjects were additionally tested at 6 months. An important facet of our study was the development and use of a novel QST modelling approach, allowing us to model all data together across modalities. We have not demonstrated significant differences in thermal thresholds between subjects with SCD and controls. Thermal thresholds were consistent over a 3- to 6-month period. Subjects on whom hydroxycarbamide (HC) was initiated shortly before or after baseline testing (new HC users) exhibited progressive decreases in thermal sensitivity from baseline to 6 months, suggesting that thermal testing may be sensitive to effective therapy to prevent vasoocclusive pain. These findings inform the use of QST as an endpoint in the evaluation of preventative pain therapies

The curious nonexistence of Gaussian 2-designs

2-designs -- ensembles of quantum pure states whose 2nd moments equal those of the uniform Haar ensemble -- are optimal solutions for several tasks in quantum information science, especially state and process tomography. We show that Gaussian states cannot form a 2-design for the continuous-variable (quantum optical) Hilbert space L2(R). This is surprising because the affine symplectic group HWSp (the natural symmetry group of Gaussian states) is irreducible on the symmetric subspace of two copies. In finite dimensional Hilbert spaces, irreducibility guarantees that HWSp-covariant ensembles (such as mutually unbiased bases in prime dimensions) are always 2-designs. This property is violated by continuous variables, for a subtle reason: the (well-defined) HWSp-invariant ensemble of Gaussian states does not have an average state because the averaging integral does not converge. In fact, no Gaussian ensemble is even close (in a precise sense) to being a 2-design. This surprising difference between discrete and continuous quantum mechanics has important implications for optical state and process tomography.Comment: 9 pages, no pretty figures (sorry!

Effect of Equation of State and Cutoff Density in Smoothed Particle Hydrodynamics Simulations of the Moon-Forming Giant Impact

The amount of vapor in the impact-generated protolunar disk carries implications for the dynamics, devolatilization, and moderately volatile element (MVE) isotope fractionation during lunar formation. The equation of state (EoS) used in simulations of the giant impact is required to calculate the vapor mass fraction (VMF) of the modeled protolunar disk. Recently, a new version of M-ANEOS ("Stewart M-ANEOS") was released with an improved treatment of heat capacity and expanded experimental Hugoniot. Here, we compare this new M-ANEOS version with a previous version ("N-SPH M-ANEOS") and assess the resulting differences in smoothed particle hydrodynamics (SPH) simulations. We find that Stewart M-ANEOS results in cooler disks with smaller values of VMF and results in differences in disk mass that are dependent on the initial impact angle. We also assess the implications of the minimum "cutoff" density ($\rho_{c}$), similar to a maximum smoothing length, that is set as a fast-computing alternative to an iteratively calculated smoothing length. We find that the low particle resolution of the disk typically results in $>40\%$ of disk particles falling to $\rho_c$, influencing the dynamical evolution and VMF of the disk. Our results show that choice of EoS, $\rho_{c}$, and particle resolution can cause the VMF and disk mass to vary by tens of percent. Moreover, small values of $\rho_{c}$ produce disks that are prone to numerical instability and artificial shocks. We recommend that future giant impact SPH studies review smoothing methods and ensure the thermodynamic stability of the disk over simulated time.Comment: To be published in The Planetary Science Journal, 51 pages, 34 figures, 4 table

Feasibility and acceptability of a remotely delivered, home-based, pragmatic resistance ‘exercise snacking’ intervention in community-dwelling older adults: A pilot randomised controlled trial

Background: Very few older adults meet current muscle strengthening exercise guidelines, and several barriers exist to supervised, community-based resistance exercise programs. Older adults therefore require access to feasible resistance exercise modalities that may be performed remotely. This pilot study assessed the feasibility and acceptability of undertaking a four-week home-based resistance ‘exercise snacking’ intervention (performed either once, twice, or thrice daily) when delivered and monitored remotely in older adults. Methods: Thirty-eight community-dwelling older adults [mean ± SD age 69.8 ± 3.8 y, 63% female] were randomised to complete resistance ‘exercise snacks’ (9-minute sessions) either once (n = 9), twice (n = 10), or thrice (n = 9) daily, or allocated to usual-activity control (n = 10). Exercise adherence and adverse events were assessed using an exercise diary, and acceptability of the intervention was explored using an online questionnaire. Physical function [balance, 5-times sit-to-stand (STS), and 30-second STS tests] was assessed remotely at baseline and follow-up using videoconferencing. Results: The intervention was feasible and safe, with 100% participant retention, high adherence (97, 82, and 81% for once, twice, and thrice daily, respectively), and only two adverse events from a total of 1317 ‘exercise snacking’ sessions. The exercise intervention was rated as enjoyable (75% reported their enjoyment as ≥ 4 on a 5-point Likert scale), easy to perform, and most (82%) planned to continue similar exercise at home. We also found it was feasible to assess measures of physical function via videoconferencing, although effect sizes for 4-week changes in both 5-STS (d range, 0.4–1.4) and 30-STS (d range, 0.7–0.9) following the exercise intervention were similar to controls (d = 1.1 and 1.0 for 5-STS and 30-STS, respectively). Conclusions: Resistance ‘exercise snacking’ may be a feasible strategy for engaging older adults in home-based resistance exercise when delivered and monitored remotely. The findings of this pilot feasibility trial support the need for longer-term studies in larger cohorts to determine the effectiveness of resistance ‘exercise snacking’ approaches for improving physical function in older adults. Trial registration: The trial was retrospectively registered on 10/11/2021 with the Australian New Zealand Clinical Trials Registry (ANZCTR) (ACTRN12621001538831)

Barriers and enablers associated with participation in a home-based pragmatic exercise snacking program in older adults delivered and monitored by Amazon Alexa: A qualitative study

Background: ‘Exercise snacking’, which is characterised by shorter and more frequent exercise bouts compared with traditional exercise guidelines, may be an acceptable strategy for increasing physical activity and reducing sedentary behaviour in older adults. Aim: The aim of this study was to evaluate the enablers and barriers for older adults associated with participation in a home-based exercise snacking program delivered and monitored using an Amazon Echo Show 5 device (Alexa). Methods: This study used an interpretive description qualitative design to conduct semi-structured interviews following a 12-week pilot study in 15 adults aged 60–89 years with at least one chronic condition. All participants were prescribed a home based, individualised, lower limb focussed ‘exercise snacking’ program (involving ≤ 10 min of bodyweight exercises 2–4 times per day) delivered and monitored by an Alexa. Qualitative interview data were analysed using thematic analysis. Results: All 15 participants (mean age 70.3 years) attended the semi-structured interview. Themes including time efficiency, flexibility, perceived health benefits, and motivation were enablers for participation in the ‘exercise snacking’ program. A lack of upper body exercises and omission of exercise equipment in the program, as well as a lack of time and motivation for performing exercise snacks three or more times per day, were barriers to participation. Conclusion: While ‘exercise snacking’ is acceptable for older adults, future trials should provide equipment (e.g. adjustable dumbbells, exercise bands), prescribe whole-body exercise programs, and establish strategies to support participation in more than three exercise snacks per day

Barriers and enablers for older adults participating in a home-based pragmatic exercise program delivered and monitored by Amazon Alexa: a qualitative study

Background: The remote delivery and monitoring of individually-tailored exercise programs using voice-controlled intelligent personal assistants (VIPAs) that support conversation-based interactions may be an acceptable alternative model of digital health delivery for older adults. The aim of this study was to evaluate the enablers and barriers for older adults participating in a home-based exercise program delivered and monitored by VIPAs. Method: This qualitative study used videoconferencing to conduct semi-structured interviews following a 12-week, prospective single-arm pilot study in 15 adults aged 60 to 89 years living alone in the community. All participants were prescribed an individualized, brief (10 min, 2–4 times per day), home-based muscle strengthening and balance exercise program delivered and monitored using an Amazon Echo Show 5 device (Alexa). Qualitative interview data were analysed using inductive thematic analysis. Results: All 15 participants (aged 70.3 ± 4.3 years, mean ± SD) attended the semi-structured interview. Themes including enjoyability and ease of use, social engagement and motivation were enablers for participation in the exercise program. Errors in voice recognition, lack of feedback, and preference for other existing digital health modes of exercise delivery were barriers associated with the Alexa technology. Conclusions: This qualitative study identified enablers and barriers associated with using an Alexa device to deliver and monitor an individualized, home-based exercise program in older adults living alone. Future interventions using VIPAs should focus on reducing technical errors, providing regular exercise feedback, and comparing participants’ experiences of exercise programs delivered by VIPAs to programs delivered via other digital health tools