Participant perceptions of physical activity-enhancing interventions for adults with disability: A meta-synthesis of qualitative research

The United Nations Convention on the Rights of Persons with Disabilities enshrines the rights of disabled people to access services in all areas of citizenship including participation in recreational, leisure and sport activities. Despite this protection, people with disabilities face multiple personal, environmental and social barriers to participation in physical activity (PA). As a result, disabled people are more likely to be inactive compared to the able bodied population and are at a greater risk of inactivity-related diseases. Thus, there is an urgent need for behaviour change interventions to increase PA by specifically addressing the situations of people with disabilities and their barriers to participation. This original meta-synthesis of qualitative research was undertaken to explore participants’ perceptions of PA-enhancing interventions for adults with physical disability. To identify published articles relevant to the meta-synthesis, a rigorous systematic search of electronic databases and hand search of relevant journals was undertaken. In total, 76 papers were read in full, and based on the inclusion criteria, 10 papers were included for review. Following a critical appraisal of the papers, methods of thematic synthesis were drawn upon to generate analytical themes through interpretation and conceptual synthesis. Seven interrelated analytical themes were constructed representing both components and outcomes of the interventions. These were: (i) social support; (ii) diversity; (iii) communication; (iv) behavioural strategies; (v) changing thoughts; (vi) knowledge; (vii) health and well-being. The results of this meta-synthesis provide significant new information that will help interventionists design more effective PA-enhancing interventions, and researchers to better identify and measure key mechanisms and outcomes associated with successful PA-enhancing interventions for people with disabilities

User needs elicitation via analytic hierarchy process (AHP). A case study on a Computed Tomography (CT) scanner

Background: The rigorous elicitation of user needs is a crucial step for both medical device design and purchasing. However, user needs elicitation is often based on qualitative methods whose findings can be difficult to integrate into medical decision-making. This paper describes the application of AHP to elicit user needs for a new CT scanner for use in a public hospital. Methods: AHP was used to design a hierarchy of 12 needs for a new CT scanner, grouped into 4 homogenous categories, and to prepare a paper questionnaire to investigate the relative priorities of these. The questionnaire was completed by 5 senior clinicians working in a variety of clinical specialisations and departments in the same Italian public hospital. Results: Although safety and performance were considered the most important issues, user needs changed according to clinical scenario. For elective surgery, the five most important needs were: spatial resolution, processing software, radiation dose, patient monitoring, and contrast medium. For emergency, the top five most important needs were: patient monitoring, radiation dose, contrast medium control, speed run, spatial resolution. Conclusions: AHP effectively supported user need elicitation, helping to develop an analytic and intelligible framework of decision-making. User needs varied according to working scenario (elective versus emergency medicine) more than clinical specialization. This method should be considered by practitioners involved in decisions about new medical technology, whether that be during device design or before deciding whether to allocate budgets for new medical devices according to clinical functions or according to hospital department

Precipitation of the ordered α2 phase in a near-α titanium alloy

Precipitate evolution in a near-α alloy was studied using transmission electron microscopy (TEM) and correlative atom probe tomography (APT) after ageing at 550-700 for times up to 28 days. It is found that precipitation occurs much faster and is more prolific in samples heat treated at higher temperatures. Particles were spherical after ageing at 550 °C, while after ageing at 700 °C they become ellipsoids with the major axis lying close to the [0001] direction. At longer ageing times, the α2 precipitates were found to contain greater amounts of Sn + Si, indicating that Sn and Si are stronger Ti3(Al,Sn,Si) formers than Al

Prospects for Spin Physics at RHIC

Colliding beams of 70% polarized protons at up to $\sqrt{s}$=500 GeV, with high luminosity, L=2$\times10^{{\rm 32}}$ cm$^{-2}$sec$^{-1}$, will represent a new and unique laboratory for studying the proton. RHIC-Spin will be the first polarized-proton collider and will be capable of copious production of jets, directly produced photons, and $W$ and $Z$ bosons. Features will include direct and precise measurements of the polarization of the gluons and of $\bar{u}$, $\bar{d}$, $u$, and $d$ quarks in a polarized proton. Parity violation searches for physics beyond the standard model will be competitive with unpolarized searches at the Fermilab Tevatron. Transverse spin will explore transversity for the first time, as well as quark-gluon correlations in the proton. Spin dependence of the total cross section and in the Coulomb nuclear interference region will be measured at collider energies for the first time. These qualitatively new measurements can be expected to deepen our understanding of the structure of matter and of the strong interaction.Comment: 51 pages, 22 figures. Scheduled to appear in the Annual Review of Nuclear and Particle Science Vol. 50, to be published in December 2000 by Annual Reviews, http://AnnualReviews.or

The effect of phase chemistry on the extent of strengthening mechanisms in model Ni-Cr-Al-Ti-Mo based superalloys

The exceptional mechanical properties of polycrystalline nickel-based superalloys arise through various concurrent strengthening mechanisms. Whilst these mechanisms are generally understood, consensus has yet to be established on the precise contribution of each to the overall alloy strength. Furthermore, changes in alloy chemistry influence several different mechanisms, making the assessment of individual alloying elements complex. In this study, a series of model quinary Ni-based superalloys has been investigated to systematically study the effect of varying Mo content on the contributing strengthening mechanisms. Using microstructural data, the yield strength was modelled by summing the individual effects of solid solution in both the γ and γ ' phases, coherency, grain boundary and precipitation strengthening. The total predicted yield stress increased with Mo content despite the diminishing contribution of precipitation strengthening. It is shown that solid solution strengthening of the ordered γ' precipitate phase is a key contributor to the overall strength, and that variations in composition between the tertiary and secondary γ ' lead to significant changes in mechanical properties that should be accounted for in models of alloy strength.Funding was provided by the EPSRC/Rolls-Royce Strategic Partnership under EP/M005607/1 and EP/H022309/1. The Oxford Atom Probe facility was funded by the EPSRC under EP/M022803/1. E. I. Galindo-Nava would like to acknowledge the Royal Academy of Engineering for his fellowship funding. Neutron diffraction beam time was supported through the Canadian Neutron Beam Centre under Experiment number 1258

Indium clustering in a -plane InGaN quantum wells as evidenced by atom probe tomography

Atom probe tomography (APT) has been used to characterize the distribution of In atoms within non-polar a-plane InGaN quantum wells (QWs) grown on a GaN pseudo-substrate produced using epitaxial lateral overgrowth. Application of the focused ion beam microscope enabled APT needles to be prepared from the low defect density regions of the grown sample. A complementary analysis was also undertaken on QWs having comparable In contents grown on polar c-plane sample pseudo-substrates. Both frequency distribution and modified nearest neighbor analyses indicate a statistically non-randomized In distribution in the a-plane QWs, but a random distribution in the c-plane QWs. This work not only provides insights into the structure of non-polar a-plane QWs but also shows that APT is capable of detecting as-grown nanoscale clustering in InGaN and thus validates the reliability of earlier APT analyses of the In distribution in c-plane InGaN QWs which show no such clustering.The European Research Council has provided financial support under the European Community’s Seventh Framework Programme (FP7/2007-2013)/ERC Grant Agreement No. 279361 (MACONS). This work was also funded in part by the EPSRC (Grant Nos. EP/H047816/1, EP/H0495331 and EP/J003603/1).This is the author accepted manuscript. The final version is available via AIP at http://scitation.aip.org/content/aip/journal/apl/106/7/10.1063/1.4909514

Using the theory of planned behaviour as a process evaluation tool in randomised trials of knowledge translation strategies : A case study from UK primary care

Peer reviewedPublisher PD

The development of a theory-based intervention to promote appropriate disclosure of a diagnosis of dementia

Background: The development and description of interventions to change professional practice are often limited by the lack of an explicit theoretical and empirical basis. We set out to develop an intervention to promote appropriate disclosure of a diagnosis of dementia based on theoretical and empirical work. Methods: We identified three key disclosure behaviours: finding out what the patient already knows or suspects about their diagnosis; using the actual words 'dementia' or 'Alzheimer's disease' when talking to the patient; and exploring what the diagnosis means to the patient. We conducted a questionnaire survey of older peoples' mental health teams (MHTs) based upon theoretical constructs from the Theory of Planned Behaviour (TPB) and Social Cognitive Theory (SCT) and used the findings to identify factors that predicted mental health professionals' intentions to perform each behaviour. We selected behaviour change techniques likely to alter these factors. Results: The change techniques selected were: persuasive communication to target subjective norm; behavioural modelling and graded tasks to target self-efficacy; persuasive communication to target attitude towards the use of explicit terminology when talking to the patient; and behavioural modelling by MHTs to target perceived behavioural control for finding out what the patient already knows or suspects and exploring what the diagnosis means to the patient. We operationalised these behaviour change techniques using an interactive 'pen and paper' intervention designed to increase intentions to perform the three target behaviours. Conclusion : It is feasible to develop an intervention to change professional behaviour based upon theoretical models, empirical data and evidence based behaviour change techniques. The next step is to evaluate the effect of such an intervention on behavioural intention. We argue that this approach to development and reporting of interventions will contribute to the science of implementation by providing replicable interventions that illuminate the principles and processes underlying change.This project is funded by UK Medical Research Council, Grant reference number G0300999. Jeremy Grimshaw holds a Canada Research Chair in Health Knowledge Transfer and Uptake. Jill Francis is funded by the Chief Scientist Office of the Scottish Government Health Directorate. The views expressed in this study are those of the authors

Expression of Foxp3 in colorectal cancer but not in Treg cells correlates with disease progression in patients with colorectal cancer

Background: Regulatory T cells (Treg) expressing the transcription factor forkhead-box protein P3 (Foxp3) have been identified to counteract anti-tumor immune responses during tumor progression. Besides, Foxp3 presentation by cancer cells itself may also allow them to evade from effector T-cell responses, resulting in a survival benefit of the tumor. For colorectal cancer (CRC) the clinical relevance of Foxp3 has not been evaluated in detail. Therefore the aim of this study was to study its impact in colorectal cancer (CRC). Methods and Findings: Gene and protein analysis of tumor tissues from patients with CRC was performed to quantify the expression of Foxp3 in tumor infiltrating Treg and colon cancer cells. The results were correlated with clinicopathological parameters and patients overall survival. Serial morphological analysis demonstrated Foxp3 to be expressed in cancer cells. High Foxp3 expression of the cancer cells was associated with poor prognosis compared to patients with low Foxp3 expression. In contrast, low and high Foxp3 level in tumor infiltrating Treg cells demonstrated no significant differences in overall patient survival. Conclusions: Our findings strongly suggest that Foxp3 expression mediated by cancer cells rather than by Treg cells contribute to disease progression