Efficacy of a family practice-based lifestyle intervention program to increase physical activity and reduce clinical and physiological markers of vascular health in patients with high normal blood pressure and/or high normal blood glucose (SNAC): study protocol for a randomized controlled trial

<p>Abstract</p> <p>Background</p> <p>Previous interventions to increase physical activity and reduce cardiovascular risk factors have been targeted at individuals with established disease; less attention has been given to intervention among individuals with high risk for disease nor has there been determination of the influence of setting in which the intervention is provided. In particular, family practice represents an ideal setting for the provision and long-term maintenance of lifestyle interventions for patients at risk (ie high-normal blood pressure or impaired glucose tolerance).</p> <p>Methods/design</p> <p>The Staged Nutrition and Activity Counseling (SNAC) study is a randomized clustered design clinical trial that will investigate the effectiveness and efficacy of a multi-component lifestyle intervention on cardiovascular disease risk factors and vascular function in patients at risk in primary care. Patients will be randomized by practice to either a standard of care lifestyle intervention or a behaviourally-based, matched prescriptive physical activity and diet change program. The primary goal is to increase physical activity and improve dietary intake according to Canada's Guides to Physical Activity Healthy Eating over 24 months. The primary intention to treat analysis will compare behavioral, physiological and metabolic outcomes at 6, 12 and 24 months post-randomization including estimation of incident hypertension and/or diabetes.</p> <p>Discussion</p> <p>The design features of our trial, and the practical problems (and solutions) associated with implementing these design features, particularly those that result in potential delay between recruitment, baseline data collection, randomization, intervention, and assessment will be discussed. Results of the SNAC trial will provide scientific rationale for the implementation of this lifestyle intervention in primary care.</p> <p>Trial registration</p> <p>ISRCTN: <a href="http://www.controlled-trials.com/ISRCTN:42921300">ISRCTN:42921300</a></p

Perceptions of homoeopathic practitioners regarding continuing professional development (CPD) in South Africa

Abstract : The aim of this study was to determine the perceptions of homoeopathic practitioners in South Africa with regards to the Continuing Professional Development (CPD) programme, to determine if practitioners are aware of the programme, how it is run, what the requirements of the programme are and if they are complying to the requirements of this programme. The sample group for this study consisted of homoeopathic practitioners in South Africa that have been registered as such before the 01 July 2015, as this is when the second CPD cycle began. An online survey was set up and the link for the survey was send out to 581 practitioners, 97 practitioners elected to participate in this survey. The CPD survey (Appendix F) was created based on a previous CPD study that was used by Schostak et al. (2009) in the United Kingdom and based on the considerations of the AHPCSA’s CPD guidelines. The survey was done online with most of the questions being closed-ended, with a few open-ended questions. A total of 581 homoeopathic practitioners were emailed, whereby only 97 elected to partake in the study. All potential participants had to complete an eligibility question (Appendix D), whereby participants had to confirm being registered as a homoeopath before 01 July 2015. Respondents perceived the CPD programme as being an effective educational programme that helps to encourage skills development of professionals. The most popular level of activities that practitioners had accumulate the most Continuing Educational Units (CEUs), was for level 1, with lesser participation for high CEU earning options in level 2 and 3. The most significant negative opinion of the programme was due to costs allocated to CPD activities, which included travel expenses, accommodation expenses and lastly the attendance fees. Compliance with holding a first aid qualification was low. As this is a requirement for registration added to the associated CPD options for this criterion, first aid requirements are recommended to be reconsidered to assist with basic compliance. For smoother comprehension and compliance with CPD requirements by practitioners it is recommended that the Allied Health Practitioners Council of South Africa (AHPCSA) reconsider the matrix of CEU allocations particularly related to first aid, standardisation of congresses or course attendance. CPD providers also need to be encouraged to provide a variety of online courses as this would assist practitioners that are not based in major cities as well as considering the offering of bioethics and jurisprudence courses allowing for easy compliance for this requirement.M.Tech. (Homoeopathy

Sleep And The Pandemic:Evaluation Of Sleep Patterns During The Covid -19 Pandemic

Since the outbreak of the COVID-19 pandemic, the world has come to a standstill, with enforcement of the lockdown, several regulations, and restrictions that brought significant change to people's lifestyles, and induced waves of panic and delirium in individuals everywhere. This unfunded cross-sectional survey-based study aims to evaluate the pandemic's impact on sleep patterns in a sample of the general population worldwide. An online survey was constructed , composing of 31 questions. The Athens scale was used to estimate nocturnal sleep dysfunction and daytime dysfunction. The survey's target population was 13 years and above. 300 responses were received .A majority of the participants reported that they sleep late, have an increased screen time , and used electronics . 45% of the participants said they have insomnia and 55% of the participants claimed they did not have insomnia. Despite the majority claiming to not have insomnia, on employing the Athens scale to calculate individuals' insomnia scores, the results were quite contradictory .Nighttime routines and alarm usage were also monitored. .Therefore, this study has enabled to observe that there has been a definite impact in the sleep cycles of certain individuals since the beginning of the pandemic. Limitations of this study include sample size, random sampling and lack of additional profound dat