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

Digital payments adoption research: A meta-analysis for generalising the effects of attitude, cost, innovativeness, mobility and price value on behavioural intention

yesThe rapid evolution of mobile-based technologies and applications has led to the development of several different forms of digital payment methods (DPMs) but with limited enthusiasm in consumers for adopting them. Hence, several academic studies have already been conducted to examine the role of various antecedents that determines consumers’ intention to adopt DPMs. The degree of effect and significance of several antecedents found to be inconsistent across different studies. This provided us a basis for undertaking a meta-analysis of existing research for estimating the cumulative effect of such antecedents. Therefore, this study aims to perform a meta-analysis of five antecedents (i.e. attitude, cost, mobility, price value and innovativeness) for confirming their overall influence on intentions to adopt DPMs. The results of this study suggest that the cumulative effect of four out of five antecedents found to be significant while influence of price value was found insignificant on behavioural intentions. The recommendations drawn from this research would help to decide if and when to use such antecedents for predicting consumer intention to adopt DPMs

Parton distributions from high-precision collider data: NNPDF Collaboration

We present a new set of parton distributions, NNPDF3.1, which updates NNPDF3.0, the first global set of PDFs determined using a methodology validated by a closure test. The update is motivated by recent progress in methodology and available data, and involves both. On the methodological side, we now parametrize and determine the charm PDF alongside the light-quark and gluon ones, thereby increasing from seven to eight the number of independent PDFs. On the data side, we now include the D0 electron and muon W asymmetries from the final Tevatron dataset, the complete LHCb measurements of W and Z production in the forward region at 7 and 8 TeV, and new ATLAS and CMS measurements of inclusive jet and electroweak boson production. We also include for the first time top-quark pair differential distributions and the transverse momentum of the Z bosons from ATLAS and CMS. We investigate the impact of parametrizing charm and provide evidence that the accuracy and stability of the PDFs are thereby improved. We study the impact of the new data by producing a variety of determinations based on reduced datasets. We find that both improvements have a significant impact on the PDFs, with some substantial reductions in uncertainties, but with the new PDFs generally in agreement with the previous set at the one-sigma level. The most significant changes are seen in the light-quark flavor separation, and in increased precision in the determination of the gluon. We explore the implications of NNPDF3.1 for LHC phenomenology at Run II, compare with recent LHC measurements at 13 TeV, provide updated predictions for Higgs production cross-sections and discuss the strangeness and charm content of the proton in light of our improved dataset and methodology. The NNPDF3.1 PDFs are delivered for the first time both as Hessian sets, and as optimized Monte Carlo sets with a compressed number of replicas

Prognostic model to predict postoperative acute kidney injury in patients undergoing major gastrointestinal surgery based on a national prospective observational cohort study.

Background: Acute illness, existing co-morbidities and surgical stress response can all contribute to postoperative acute kidney injury (AKI) in patients undergoing major gastrointestinal surgery. The aim of this study was prospectively to develop a pragmatic prognostic model to stratify patients according to risk of developing AKI after major gastrointestinal surgery. Methods: This prospective multicentre cohort study included consecutive adults undergoing elective or emergency gastrointestinal resection, liver resection or stoma reversal in 2-week blocks over a continuous 3-month period. The primary outcome was the rate of AKI within 7 days of surgery. Bootstrap stability was used to select clinically plausible risk factors into the model. Internal model validation was carried out by bootstrap validation. Results: A total of 4544 patients were included across 173 centres in the UK and Ireland. The overall rate of AKI was 14·2 per cent (646 of 4544) and the 30-day mortality rate was 1·8 per cent (84 of 4544). Stage 1 AKI was significantly associated with 30-day mortality (unadjusted odds ratio 7·61, 95 per cent c.i. 4·49 to 12·90; P < 0·001), with increasing odds of death with each AKI stage. Six variables were selected for inclusion in the prognostic model: age, sex, ASA grade, preoperative estimated glomerular filtration rate, planned open surgery and preoperative use of either an angiotensin-converting enzyme inhibitor or an angiotensin receptor blocker. Internal validation demonstrated good model discrimination (c-statistic 0·65). Discussion: Following major gastrointestinal surgery, AKI occurred in one in seven patients. This preoperative prognostic model identified patients at high risk of postoperative AKI. Validation in an independent data set is required to ensure generalizability

Protected area personnel and ranger numbers are insufficient to deliver global expectations

The 2020 global spatial targets for protected areas set by the Convention on Biological Diversity have almost been achieved, but management effectiveness remains deficient. Personnel shortages are widely cited as major contributing factors but have not previously been quantified. Using data from 176 countries and territories, we estimate a current maximum of 555,000 terrestrial protected area personnel worldwide (one per 37 km2), including 286,000 rangers (one per 72 km2), far short of published guidance on required densities. Expansion by 2030 to 30% coverage of protected areas and other effective area-based conservation measures is widely agreed as a minimum for safeguarding biodiversity and ecosystem services. We project that effective management of this expanded system will require approximately 3 million personnel (one per 13 km2), including more than 1.5 million rangers or equivalents (one per 26 km2). Parallel improvements in resourcing, working conditions and capacity are required for effective, equitable and sustainable management

Negative Impacts of Human Land Use on Dung Beetle Functional Diversity

The loss of biodiversity caused by human activity is assumed to alter ecosystem functioning. However our understanding of the magnitude of the effect of these changes on functional diversity and their impact on the dynamics of ecological processes is still limited. We analyzed the functional diversity of copro-necrophagous beetles under different conditions of land use in three Mexican biosphere reserves. In Montes Azules pastures, forest fragments and continuous rainforest were analyzed, in Los Tuxtlas rainforest fragments of different sizes were analyzed and in Barranca de Metztitlán two types of xerophile scrub with different degrees of disturbance from grazing were analyzed. We assigned dung beetle species to functional groups based on food relocation, beetle size, daily activity period and food preferences, and as measures of functional diversity we used estimates based on multivariate methods. In Montes Azules functional richness was lower in the pastures than in continuous rainforest and rainforest fragments, but fragments and continuous forest include functionally redundant species. In small rainforest fragments (<5 ha) in Los Tuxtlas, dung beetle functional richness was lower than in large rainforest fragments (>20 ha). Functional evenness and functional dispersion did not vary among habitat types or fragment size in these reserves. In contrast, in Metztitlán, functional richness and functional dispersion were different among the vegetation types, but differences were not related to the degree of disturbance by grazing. More redundant species were found in submontane than in crassicaule scrub. For the first time, a decrease in the functional diversity in communities of copro-necrophagous beetles resulting from changes in land use is documented, the potential implications for ecosystem functioning are discussed and a series of variables that could improve the evaluation of functional diversity for this biological group is proposed

Mobile app stores from the user's perspectives

YesThe use of smartphones has become more prevalent in light of the boom in Internet services and Web 2.0 applications. Mobile stores (e.g., Apple’s App Store and Google Play) have been increasingly used by mobile users worldwide to download or purchase different kinds of applications. This has prompted mobile app practitioners to reconsider their mobile app stores in terms of design, features and functions in order to maintain their customers’ loyalty. Due to the lack of research on this context, this study aims to identify factors that may affect users’ satisfaction and continued intention toward using mobile stores. The proposed model includes various factors derived from information systems literature (i.e., usefulness, ease of use, perceived cost, privacy and security concerns) in addition to the dimensions of mobile interactivity (i.e. active control, mobility, and responsiveness). The study sets out 13 hypotheses that include mediating relationships (e.g., perceived usefulness mediates the influence of ease of use, active control, responsiveness and mobility; perceived ease of use mediates the influence of active control). As well as outlining the proposed research method, the research contributions, limitations and future research recommendations are also addressed

Genome Sequence and Transcriptome Analysis of the Radioresistant Bacterium Deinococcus gobiensis: Insights into the Extreme Environmental Adaptations

The desert is an excellent model for studying evolution under extreme environments. We present here the complete genome and ultraviolet (UV) radiation-induced transcriptome of Deinococcus gobiensis I-0, which was isolated from the cold Gobi desert and shows higher tolerance to gamma radiation and UV light than all other known microorganisms. Nearly half of the genes in the genome encode proteins of unknown function, suggesting that the extreme resistance phenotype may be attributed to unknown genes and pathways. D. gobiensis also contains a surprisingly large number of horizontally acquired genes and predicted mobile elements of different classes, which is indicative of adaptation to extreme environments through genomic plasticity. High-resolution RNA-Seq transcriptome analyses indicated that 30 regulatory proteins, including several well-known regulators and uncharacterized protein kinases, and 13 noncoding RNAs were induced immediately after UV irradiation. Particularly interesting is the UV irradiation induction of the phrB and recB genes involved in photoreactivation and recombinational repair, respectively. These proteins likely include key players in the immediate global transcriptional response to UV irradiation. Our results help to explain the exceptional ability of D. gobiensis to withstand environmental extremes of the Gobi desert, and highlight the metabolic features of this organism that have biotechnological potential