1,315 research outputs found

    Clinical engagement in primary care-led commissioning:a review of the evidence

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    A qualitative study of the experiences and perceptions of adults with chronic musculoskeletal conditions following a 12-week Pilates exercise programme

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    Introduction The aim of the present study was to explore the experiences and perceptions of adult patients with chronic musculoskeletal conditions following a Pilates exercise programme. A qualitative approach was taken to both data collection and analysis, with alignment to the philosophy of interpretive phenomenology. Participants included 15 women and seven men with a range of chronic musculoskeletal conditions, including nonspecific low back pain, peripheral joint osteoarthritis and a range of postsurgical conditions. The age range was from 36 years to 83 years, and the mean age was 57 years (standard deviation 14.1 years). Methods Data were collected via digital recordings of four focus groups in three North‐West of England physiotherapy clinics. The data were transcribed verbatim and then analysed using a thematic framework. Data were verified by a researcher and randomly selected participants, and agreement was achieved between all parties. Results The results were organized into five main themes: physical improvements; Pilates promotes an active lifestyle: improved performance at work and hobbies; psychosocial benefits and improved confidence; increased autonomy in managing their own condition; and motivation to continue with exercise. Conclusion The study was the first to investigate individual perceptions of the impact of Pilates on the daily lives of people with chronic conditions. The Pilates‐based exercise programme enabled the participants to function better and manage their condition more effectively and independently. Further to previous work, the study revealed psychological and social benefits which increase motivation to adhere to the programme and promote a healthier lifestyle

    Exploring the early workings of emerging Clinical Commissioning Groups: Final report

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    Basic Hypergeometric Functions and Covariant Spaces for Even Dimensional Representations of U_q[osp(1/2)]

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    Representations of the quantum superalgebra U_q[osp(1/2)] and their relations to the basic hypergeometric functions are investigated. We first establish Clebsch-Gordan decomposition for the superalgebra U_q[osp(1/2)] in which the representations having no classical counterparts are incorporated. Formulae for these Clebsch-Gordan coefficients are derived, and it is observed that they may be expressed in terms of the QQ-Hahn polynomials. We next investigate representations of the quantum supergroup OSp_q(1/2) which are not well-defined in the classical limit. Employing the universal T-matrix, the representation matrices are obtained explicitly, and found to be related to the little Q-Jacobi polynomials. Characteristically, the relation Q = -q is satisfied in all cases. Using the Clebsch-Gordan coefficients derived here, we construct new noncommutative spaces that are covariant under the coaction of the even dimensional representations of the quantum supergroup OSp_q(1/2).Comment: 16 pages, no figure

    Strangeness, charm and bottom in a chiral quark-meson model

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    In this paper we investigate an SU(3) extension of the chiral quark-meson model. The spectra of baryons with strangeness, charm and bottom are considered within a "rigid oscillator" version of this model. The similarity between the quark part of the Lagrangian in the model and the Wess-Zumino term in the Skyrme model is noted. The binding energies of baryonic systems with baryon number B=2 and 3 possessing strangeness or heavy flavor are estimated. The results obtained are in good qualitative agreement with those obtained previously in the topological soliton (Skyrme) model.Comment: 12 pages, no figures. Journal ref: submitted to Nucl.Phys.

    Insect herbivory and herbivores of Ficus species along a rain forest elevational gradient in Papua New Guinea

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    Classic research on elevational gradients in plant–herbivore interactions holds that insect herbivore pressure is stronger under warmer climates of low elevations. However, recent work has questioned this paradigm, arguing that it oversimplifies the ecological complexity in which plant–insect herbivore interactions are embedded. Knowledge of antagonistic networks of plants and herbivores is however crucial for understanding the mechanisms that govern ecosystem functioning. We examined herbivore damage and insect herbivores of eight species of genus Ficus (105 saplings) and plant constitutive defensive traits of two of these species, along a rain forest elevational gradient of Mt. Wilhelm (200–2,700 m a.s.l.), in tropical Papua New Guinea. We report overall herbivore damage 2.4% of leaf area, ranging from 0.03% in Ficus endochaete at 1,700 m a.s.l. to 6.1% in F. hombroniana at 700 m a.s.l. Herbivore damage and herbivore abundances varied significantly with elevation, as well as among the tree species, and between the wet and dry season. Community‐wide herbivore damage followed a hump‐shaped pattern with the peak between 700 and 1,200 m a.s.l. and this pattern corresponded with abundance of herbivores. For two tree species surveyed in detail, we observed decreasing and hump‐shaped patterns in herbivory, in general matching the trends found in the set of plant defenses measured here. Our results imply that vegetation growing at mid‐elevations of the elevational gradient, that is at the climatically most favorable elevations where water is abundant, and temperatures still relatively warm, suffers the maximum amount of herbivorous damage which changes seasonally, reflecting the water availability

    Brief encounters: what do primary care professionals contribute to peoples' self-care support network for long-term conditions? A mixed methods study.

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    BACKGROUND: Primary care professionals are presumed to play a central role in delivering long-term condition management. However the value of their contribution relative to other sources of support in the life worlds of patients has been less acknowledged. Here we explore the value of primary care professionals in people's personal communities of support for long-term condition management. METHODS: A mixed methods survey with nested qualitative study designed to identify relationships and social network member's (SNM) contributions to the support work of managing a long-term condition conducted in 2010 in the North West of England. Through engagement with a concentric circles diagram three hundred participants identified 2544 network members who contributed to illness management. RESULTS: The results demonstrated how primary care professionals are involved relative to others in ongoing self-care management. Primary care professionals constituted 15.5 % of overall network members involved in chronic illness work. Their contribution was identified as being related to illness specific work providing less in terms of emotional work than close family members or pets and little to everyday work. The qualitative accounts suggested that primary care professionals are valued mainly for access to medication and nurses for informational and monitoring activities. Overall primary care is perceived as providing less input in terms of extended self-management support than the current literature on policy and practice suggests. Thus primary care professionals can be described as providing 'minimally provided support'. This sense of a 'minimally' provided input reinforces limited expectations and value about what primary care professionals can provide in terms of support for long-term condition management. CONCLUSIONS: Primary care was perceived as having an essential but limited role in making a contribution to support work for long-term conditions. This coalesces with evidence of a restricted capacity of primary care to take on the work load of self-management support work. There is a need to prioritise exploring the means by which extended self-care support could be enhanced out-with primary care. Central to this is building a system capable of engaging network capacity to mobilise resources for self-management support from open settings and the broader community

    Determination of the b quark mass at the M_Z scale with the DELPHI detector at LEP

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    An experimental study of the normalized three-jet rate of b quark events with respect to light quarks events (light= \ell \equiv u,d,s) has been performed using the CAMBRIDGE and DURHAM jet algorithms. The data used were collected by the DELPHI experiment at LEP on the Z peak from 1994 to 2000. The results are found to agree with theoretical predictions treating mass corrections at next-to-leading order. Measurements of the b quark mass have also been performed for both the b pole mass: M_b and the b running mass: m_b(M_Z). Data are found to be better described when using the running mass. The measurement yields: m_b(M_Z) = 2.85 +/- 0.18 (stat) +/- 0.13 (exp) +/- 0.19 (had) +/- 0.12 (theo) GeV/c^2 for the CAMBRIDGE algorithm. This result is the most precise measurement of the b mass derived from a high energy process. When compared to other b mass determinations by experiments at lower energy scales, this value agrees with the prediction of Quantum Chromodynamics for the energy evolution of the running mass. The mass measurement is equivalent to a test of the flavour independence of the strong coupling constant with an accuracy of 7 permil.Comment: 24 pages, 10 figures, Accepted by Eur. Phys. J.
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