ORCID Profile
0000-0002-0473-5157
Current Organisation
University of South Australia
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Publisher: Springer Science and Business Media LLC
Date: 06-02-2010
Publisher: Wiley
Date: 21-11-2013
DOI: 10.1111/RESP.12201
Abstract: While recommendations for the duration, frequency, mode and intensity of exercise programmes for people with chronic obstructive pulmonary disease (COPD) are specified in consensus statements, criteria for exercise session attendance are less clear. The review questions were: (i) how commonly are a priori criteria and attendance rates reported for people with COPD participating in exercise programmes and (ii) what is the strength of association between attendance and improvements in functional exercise capacity. Database searches identified primary studies of people with COPD participating in exercise or pulmonary rehabilitation programmes of at least 2 weeks duration. Primary outcomes were a priori criteria for attendance, reports of attendance at supervised exercise sessions and mean improvements in functional exercise assessments. Data extraction processes were confirmed prospectively (>80% agreement). Variants of exercise attendance data were described. Linear associations between attendance and improvements in exercise outcomes were explored (Pearson r, P < 0.05). Of the 234 included studies, 86 (37%) reported attendance and 29 (12%) provided a priori criteria for attendance. In the small s le of studies which reported attendance and functional exercise data before and after the intervention, there was little to no relationship between improvements in functional exercise capacity and training volume (prescribed r = -0.03, P = 0.88 attended r = -0.24, P = 0.18). Reporting of exercise programme attendance rates is low and of variable quality for people with COPD. Consistent and explicit reporting of exercise attendance in people with COPD will enable calculation of dose-response relationships and determine the value of a priori exercise attendance criteria.
Publisher: University of Toronto Press Inc. (UTPress)
Date: 02-2018
Publisher: The Haworth Press
Date: 2008
Abstract: Health Related Quality of Life (HRQOL) is an important outcome in the delivery of health care. Research on the HRQOL in young people with cerebral palsy (CP) has relied on proxy-reports from parents. The purpose of this study was to investigate the self-reported HRQOL of young people with CP. A survey was mailed to 229 adolescents with CP in South Australia, of which 118 responded (51.5%). Seventy-one participants 11 to 17 years of age, self-reported HRQOL on the Pediatric Quality of Life Inventory 4.0 (PedsQL). Thirty-eight youth were deemed by their parent/guardian as having insufficient cognitive ability to self-report HRQOL and nine respondents returned their surveys incomplete. The mean PedsQL Physical Function score was 57.3 (SD = 24.3), the mean Psychosocial Function score was 64.5 (SD = 15.9), and the Overall PedsQL score was 62.0 (SD = 16.7). Compared to norms for children without disabilities, 67% of participants had an Overall PedsQL score greater than 1 SD below the mean. PedsQL scores were related to gross motor function classification level (Spearman's rho = -0.54), number of health issues (rho = -0.51), and socioeconomic status (rho = 0.28), but not age, gender, quality of sleep, or whether parent assistance was needed to complete the PedsQL. The results have implications for policy and efforts to identify and address barriers to full and satisfying participation in mainstream schools and community activities.
Publisher: Informa UK Limited
Date: 1994
Publisher: Elsevier BV
Date: 09-2008
Abstract: If descriptors of the sensation of breathlessness are able to differentiate between medical conditions, the language of breathlessness could potentially have a role in differential diagnosis. This study investigated whether the language used to describe the sensation of breathlessness accurately categorized older in iduals with and without a prior diagnosis of COPD. Using a parallel-group design, participants with and without a prior diagnosis of COPD volunteered words and phrases and endorsed up to three statements to describe their sensation of breathlessness. Cluster analysis (v-fold cross-validation) was applied, and subjects were clustered by their choice of words. Cluster membership was then compared to original group membership (COPD vs non-COPD), and predictive power was assessed. Groups were similar for age and gender (COPD, n = 94 48 men mean age, 70 +/- 10 years [+/- SD] vs non-COPD, n = 55 21 men mean age, 69 +/- 13 years) but differed significantly in breathlessness-related impairment, intensity, and quality of life (p < 0.0001). Cluster membership corresponded accurately with original group classifications (volunteered, 85% and up to three statements, 68% agreement). Classification based on a single best descriptor (volunteered [62%] or endorsed [55%]) was less accurate for group membership. Language used to describe the sensation of breathlessness differentiated people with and without a prior diagnosis of COPD when descriptors were not limited to a single best word or statement.
Publisher: Informa UK Limited
Date: 2017
DOI: 10.2147/COPD.S123933
Publisher: Springer Science and Business Media LLC
Date: 11-2016
Abstract: Administration of glucocorticoids (GCs) to women at risk of preterm delivery reduces the newborn's risk of respiratory distress syndrome (RDS) by 35% to 40% however, not all infants respond to this treatment. Fetal growth restriction (FGR) increases the risk of prematurity, perinatal morbidity, and mortality. This review aims to synthesize current evidence reporting the difference in RDS risk between FGR and normally grown infants (Question 1) and whether antenatal GC administration reduces the risk of RDS morbidity in FGR infants (Question 2). Systematic searches were performed, and after screening, a total of 27 and 9 citations were eligible for inclusion for Questions 1 and 2, respectively. In order to answer the two questions, odds ratios and 95% confidence intervals were calculated for all studies. The evidence was equivocal for a difference in risk of RDS in FGR compared with normally grown infants. Despite antenatal GC administration, there was evidence suggesting that the risk of RDS persists in FGR infants. The range of risk of RDS morbidity observed between studies is likely influenced by the definitions (RDS and FGR), gestational age, and small s le sizes of FGR infants evaluated. In addition, RDS morbidity may be related to the heterogeneous nature of FGR etiologies (including maternal, placental, and/or fetal factors). Further understanding of RDS morbidity and responsiveness to current treatments in FGR infants at a range of gestational ages, larger s le sizes, and stratification according to the specific etiology of FGR, may lead to improved respiratory outcomes at birth in this obstetric subpopulation.
Publisher: Elsevier BV
Date: 02-2020
DOI: 10.1016/J.JPAINSYMMAN.2019.10.012
Abstract: Explanations provided by health professionals may underpin helpful or harmful symptom beliefs and expectations of people living with chronic breathlessness. This study sought perspectives from health professionals with clinical/research expertise in chronic breathlessness on priority issues in chronic breathlessness explanations and research. Authors (n = 74) of publications specific to chronic breathlessness were invited to a three-round Delphi survey. Responses to open-ended questions (Round 1 "What is important to: include/avoid when explaining chronic breathlessness prioritize in research?") were transformed to Likert scale (1-9) items for rating in subsequent rounds. A priori consensus was defined as ≥70% of respondents rating an item as important (Likert rating 7-9) and interquartile range ≤2. Of the 31 Round 1 respondents (nine countries, five professional disciplines), 24 (77%) completed Rounds 2 and 3. Sixty-three items met consensus (include n = 28 avoid n = 9 research n = 26). Explanations of chronic breathlessness should use patient-centered communication acknowledge the distress, variability, and importance of this sensation emphasize current management principles clarify maladaptive beliefs and expectations and avoid moral culpability and inappropriate reassurance. Research priorities included the need 1) for a comprehensive understanding of breathlessness science 2) to optimize, explore, and develop effective interventions, both pharmacological and nonpharmacological and 3) determine effective models of care including strategies for education and training of health professionals and people caring for, or living with, chronic breathlessness. These consensus-based concepts for chronic breathlessness explanations and research provide a starting point for conversations between patients, carers, clinicians, and researchers within the chronic breathlessness community.
Publisher: Elsevier BV
Date: 08-2005
DOI: 10.1016/J.ICCN.2004.08.006
Abstract: This randomized cross over study aimed to compare the severity and incidences of desaturation and bradycardia between the partially ventilated endotracheal suction method (PVETS) and closed tracheal suction system (CTSS) in extremely preterm neonates. Fifteen intubated and ventilated extremely low birth weight preterm infants (mean birth weight 689g) randomly underwent both suction techniques within a 12-h period to obtain a paired reading group. The process was repeated 24-48h apart until three pairs of reading groups were collected. Changes in oxygen saturation measured with pulse oximetry and heart rate changes measured with electrocardiogram were recorded using Hewlett-Packard m240A monitor trending software. The mean of each parameter's variation from baseline was obtained using SPSS descriptive statistics and analyzed using SPSS repeated measures ANOVA. Fisher Exact Test was used to analyze the incidence of desaturation and bradycardia. The closed tracheal suction system reported a significantly smaller degree of oxygen saturation fall (P<0.005) and significantly fewer incidences of desaturation. There was also a significantly smaller degree of heart rate reduction although episodes of bradycardia were not significantly different between the two methods. Oxygen saturation and heart rate were significantly more stable during the use of CTSS compared to PVETS in the extremely low birth weight preterm population.
Publisher: Elsevier BV
Date: 09-2005
Publisher: Elsevier BV
Date: 08-2010
Abstract: Previous studies of the qualitative sensation of breathlessness have suggested that greater sensory discomfort is reported as airflow obstruction increases. This study investigated relationships between the language of breathlessness and severity of impairment in subjects with COPD. Using a prospective, observational approach, subjects completed a structured interview in which they volunteered words to describe their sensation of breathlessness and endorsed statements from a preexisting descriptor list. Global impairment was assessed by the BMI, airflow obstruction, dyspnea, and exercise capacity (BODE) index. Independent t tests and logistic regression analyses (odds ratios) were used to assess relationships between language categories and severity of impairment. In this group of 91 people (47 men, 70 +/- 10 years of age, percent predicted FEV(1) 54 +/- 23), subjects volunteering extreme affective descriptors (frightening, awful, worried) had greater impairment (BODE index, perceived respiratory disability, functional exercise capacity, and airways obstruction), and this language category was significantly associated with increasing BODE index scores (odds ratio [OR] = 1.49 95% CI, 1.18 to 1.86 P = .001). Descriptors denoting heavy, rapid, more, shallow, or does not go in or out all the way were significantly less likely to be selected as BODE index scored increased (OR = 0.75 95% CI, 0.16 to 0.93). Affective descriptors or the emotional response to the sensation of breathlessness have a significant relationship with severity of COPD impairments. Affective descriptors may reflect the degree of threat imposed by the sensation and predict the likelihood of long-term behavioral changes.
Publisher: Daedalus Enterprises
Date: 09-2012
Abstract: This study investigated whether descriptors of breathlessness differed after participation in an 8 week pulmonary rehabilitation program and whether changes in sensory quality would be reflected in responsiveness to pulmonary rehabilitation. People with COPD provided descriptors for their sensation of breathlessness before and after an 8 week pulmonary rehabilitation program. Primary outcomes for responsiveness to pulmonary rehabilitation were the 6 minute walk distance (6MWD) and the St George Respiratory questionnaire. Significant proportional shifts for sensory categories after rehabilitation were identified using the McNemar test. Random effects mixed modeling was used to determine significance of differences for primary outcomes between subjects modifying or not modifying descriptors of breathlessness. Of the 107 people referred to the pulmonary rehabilitation program, 94 met the spirometric criteria for COPD, with 58 having data for pre and post assessments (36 males, 71 ± 9 years old, percent of predicted FEV(1) 58 ± 24%). A significant proportion of subjects reduced descriptors of air hunger (P = .03, odds ratio 0.31, 95% CI 0.09-0.89) and depressed, regret, helpless (P = .04, odds ratio 0.36, 95% CI 0.10-1.05) following rehabilitation. Subjects reducing their use of descriptors of air hunger had greater improvements in the 6MWD after rehabilitation (P = .006, mean increase 46 m). The sensory quality of breathlessness was modified for approximately one third of subjects after pulmonary rehabilitation, with significant improvements in the 6MWD for subjects who reduced their use of descriptors of air hunger.
Publisher: Royal College of General Practitioners
Date: 02-2023
Abstract: Evidence about the delays to diagnosis for patients presenting with breathlessness is lacking. To explore current care of patients with breathlessness through the experiences of adults presenting with chronic breathlessness who are awaiting a diagnosis and the experiences of primary care clinicians. Qualitative study with adults presenting with chronic breathlessness and clinicians across 10 general practices. Semi-structured interviews were conducted with patients and clinicians. Participants were recruited from a feasibility cluster randomised controlled trial investigating a structured diagnostic pathway for breathlessness. An interview guide explored experiences of help seeking for breathlessness, the diagnostic process, and associated health care. Transcripts were analysed using thematic analysis supported by NVivo software. Interviews were conducted with 34 patients (mean age 68 years, standard deviation [SD] 10.8, of whom 20 were female [59%]) and 10 clinicians (mean 17 years of experience, SD 6.3, of whom five were female [50%]). Five themes were identified: recognising and validating symptoms of breathlessness is an important first step clinical decision making for breathlessness is complex difficult conversations arise when a disease-related diagnosis is not confirmed disease management rather than symptom management is prioritised by clinicians and patient experience is influenced by clinician communication style. The findings indicate potential explanations for delays to diagnosis for patients with chronic breathlessness. Interventions are needed to enhance symptom recognition, include alternative approaches to incremental investigation, and expand the concept of diagnosis beyond a disease label to improve communication, with the ultimate aim of earlier diagnosis and management to improve patient outcomes.
Publisher: Cambridge University Press (CUP)
Date: 06-2004
DOI: 10.1017/S1460396905000129
Abstract: background: verification of radiation therapy treatment using electronic portal images (epi) involves the correlation between a reference image and a treatment epi. this paper investigates the accuracy and confidence in reference anatomy outlining and anatomy matching components of epi review, when performed by radiation therapists with varying experience in epi analysis. methods: thirty radiation therapists performed reference anatomy contouring and anatomy matching of seven pairs of reference and treatment images belonging to five previous patients. accuracy was determined by the discrepancy (mm) between the anatomy contouring and matching of the subjects and the original parameters completed by an experienced senior radiation therapist, with formal training in epi analysis. confidence was recorded on a 10cm visual-analogue scale (vas). results: no significant differences were found in the accuracy of anatomy contouring or anatomy matching between subjects with and without formal epi training nor between subjects with less than or greater than five or more years of radiation therapy experience ( p 0.18). significantly different confidence scores were found in subjects with formal training in epi ( p 0.00006) conclusions: accuracy of anatomy contouring and matching was not significantly influenced by the years of radiation therapy experience and formal epi training, although these factors did affect subjects' confidence in performing epi review tasks. frequent exposure to portal image analysis may be as or more important to the technical skills required in epi review, than formal training or years of experience.
Publisher: Wiley
Date: 19-11-2015
DOI: 10.1002/NAU.22520
Abstract: To collect and categorize descriptors of "desire to void" sensation, determine the reliability of descriptor categories and assess whether descriptor categories discriminate between people with and without symptoms of overactive bladder. This observational, repeated measures study involved 64 Australian volunteers (47 female), aged 50 years or more, with and without symptoms of overactive bladder. Descriptors of desire to void sensation were derived from a structured interview (conducted on two occasions, 1 week apart). Descriptors were recorded verbatim and categorized in a three-stage process. Overactive bladder status was determined by the Overactive Bladder Awareness Tool and the Overactive Bladder Symptom Score. McNemar's test assessed the reliability of descriptors volunteered between two occasions and Partial Least Squares Regression determined whether language categories discriminated according to overactive bladder status. Post hoc Chi squared analysis and relative risk calculation determined the size and direction of overactive bladder prediction. Thirteen language categories (Urgency, Fullness, Pressure, Tickle/tingle, Pain/ache, Heavy, Normal, Intense, Sudden, Annoying, Uncomfortable, Anxiety, and Unique somatic) encapsulated 344 descriptors of sensation. Descriptor categories were stable between two interviews. The categories "Urgency" and "Fullness" predicted overactive bladder status. Participants who volunteered "Urgency" descriptors were twice as likely to have overactive bladder and participants who volunteered "Fullness" descriptors were almost three times as likely not to have overactive bladder. The sensation of desire to void is reliably described over sessions separated by a week, the language used reflects multiple dimensions of sensation, and can predict overactive bladder status.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 11-1999
DOI: 10.1097/00007632-199911010-00015
Abstract: A Cross-sectional, observational study, examining the effects of backpack weight on adolescent posture. To investigate the response of the craniovertebral angle to backpack load. There is a widely held belief that repeated carrying of heavy loads, such as school backpacks, places additional stress on rapidly growing adolescent spinal structures, making them prone to postural change. Ten volunteer state high schools in metropolitan Adelaide, South Australia, provided 985 students, aged 12 to 18 years and from five different high school years, for this study. Students' posture was measured with and without their school backpack. All data analyses were undertaken per school year level to account for specific load-carrying requirements and spinal development associated with the age group. A significant change in craniovertebral angle was found at every year level, when comparing standing posture with no backpack with posture when carrying a backpack. The change was greatest for the youngest students. Incremental change in craniovertebral angle was not strongly associated with backpack loads. The association became stronger for the oldest girls when controlled for body mass index and for weight. The results support a differential postural response per gender and per level of spinal development but also suggest that the craniovertebral angle may not be the most sensitive measure of head-on-neck postural change for adolescents.
Publisher: Elsevier BV
Date: 08-2000
DOI: 10.1016/S0003-6870(00)00002-8
Abstract: This paper describes adolescent low back pain and tests its associations with environmental features of backpack load, time spent carrying loads, time sitting, and time playing sport, using data from 1269 adolescents in twelve volunteer high schools in Adelaide, South Australia. Backpacks were the preferred method of load carrying, two-thirds of wearers preferring to carry the load over two shoulders. The average load weighed 5.3 kg (approximating 10% of body weight). The youngest students carried approximately the same amount as the oldest students. Girls were more likely than boys to report recent low back pain, and there were gender- and age-specific associations between recent low back pain, the amount of time spent sitting, the backpack load and time spent carrying it, and time playing sport. Body mass was not a confounder of any association. These findings support ongoing concerns regarding environmental contributions to adolescent low back pain.
Publisher: Wiley
Date: 12-02-2020
DOI: 10.1111/JORC.12321
Publisher: Springer Science and Business Media LLC
Date: 29-11-2011
Publisher: Informa UK Limited
Date: 26-08-2010
Publisher: JMIR Publications Inc.
Date: 03-03-2021
DOI: 10.2196/17023
Abstract: Mobile ecological momentary assessment (mEMA) permits real-time capture of self-reported participant behaviors and perceptual experiences. Reporting of mEMA protocols and compliance has been identified as problematic within systematic reviews of children, youth, and specific clinical populations of adults. This study aimed to describe the use of mEMA for self-reported behaviors and psychological constructs, mEMA protocol and compliance reporting, and associations between key components of mEMA protocols and compliance in studies of nonclinical and clinical s les of adults. In total, 9 electronic databases were searched (2006-2016) for observational studies reporting compliance to mEMA for health-related data from adults ( years) in nonclinical and clinical settings. Screening and data extraction were undertaken by independent reviewers, with discrepancies resolved by consensus. Narrative synthesis described participants, mEMA target, protocol, and compliance. Random effects meta-analysis explored factors associated with cohort compliance (monitoring duration, daily prompt frequency or schedule, device type, training, incentives, and burden score). Random effects analysis of variance (P≤.05) assessed differences between nonclinical and clinical data sets. Of the 168 eligible studies, 97/105 (57.7%) reported compliance in unique data sets (nonclinical=64/105 [61%], clinical=41/105 [39%]). The most common self-reported mEMA target was affect (primary target: 31/105, 29.5% data sets secondary target: 50/105, 47.6% data sets). The median duration of the mEMA protocol was 7 days (nonclinical=7, clinical=12). Most protocols used a single time-based (random or interval) prompt type (69/105, 65.7%) median prompt frequency was 5 per day. The median number of items per prompt was similar for nonclinical (8) and clinical data sets (10). More than half of the data sets reported mEMA training (84/105, 80%) and provision of participant incentives (66/105, 62.9%). Less than half of the data sets reported number of prompts delivered (22/105, 21%), answered (43/105, 41%), criterion for valid mEMA data (37/105, 35.2%), or response latency (38/105, 36.2%). Meta-analysis (nonclinical=41, clinical=27) estimated an overall compliance of 81.9% (95% CI 79.1-84.4), with no significant difference between nonclinical and clinical data sets or estimates before or after data exclusions. Compliance was associated with prompts per day and items per prompt for nonclinical data sets. Although widespread heterogeneity existed across analysis (I2 %), no compelling relationship was identified between key features of mEMA protocols representing burden and mEMA compliance. In this 10-year s le of studies using the mEMA of self-reported health-related behaviors and psychological constructs in adult nonclinical and clinical populations, mEMA was applied across contexts and health conditions and to collect a range of health-related data. There was inconsistent reporting of compliance and key features within protocols, which limited the ability to confidently identify components of mEMA schedules likely to have a specific impact on compliance.
Publisher: Springer Science and Business Media LLC
Date: 11-2020
DOI: 10.1140/EPJC/S10052-020-08509-3
Abstract: A search is presented for four-top-quark production using an integrated luminosity of 139 fb $$^{-1}$$ - 1 of proton–proton collision data at a centre-of-mass energy of $$13~\\text {TeV}$$ 13 TeV collected by the ATLAS detector at the LHC. Events are selected if they contain a same-sign lepton pair or at least three leptons (electrons or muons). Jet multiplicity, jet flavour and event kinematics are used to separate signal from the background through a multivariate discriminant, and dedicated control regions are used to constrain the dominant backgrounds. The four-top-quark production cross section is measured to be $$24^{+7}_{-6}$$ 24 - 6 + 7 fb. This corresponds to an observed (expected) significance with respect to the background-only hypothesis of 4.3 (2.4) standard deviations and provides evidence for this process.
Publisher: European Respiratory Society (ERS)
Date: 28-02-2010
Publisher: Elsevier BV
Date: 2001
DOI: 10.1016/S0004-9514(14)60270-1
Abstract: Chest physiotherapy is an essential part of the management of cystic fibrosis, yet comparatively few studies have investigated the commonly used forms of chest physiotherapy during acute respiratory exacerbations. Fifteen subjects with cystic fibrosis and predominantly mild pulmonary impairment completed a randomised cross-over trial with 24 hours between treatments. The active cycle of breathing techniques (ACBT) assisted by a physiotherapist was compared with the ACBT performed independently by the patient. Measurement outcomes included pulmonary function tests, indirect calorimetry and oximetry parameters. Energy expenditure was not significantly different between the two treatment regimens, though significant improvements in pulmonary function were apparent 24 hours following the therapist-assisted ACBT. In this group of subjects, neither form of treatment proved superior in terms of energy consumption, but a reduction in airways obstruction was observed as a carry-over effect following the therapist-assisted ACBT.
Publisher: Wiley
Date: 21-05-2007
DOI: 10.1111/J.1469-8749.2007.00450.X
Abstract: Participation in regular physical activity (PA) provides health, psychological, and physiological benefits for people with and without a physical disability. This study investigated the physical and sedentary activity patterns of adolescents with cerebral palsy (CP). A cross-sectional, descriptive, postal survey was used, consisting of the Physical Activity Questionnaire for Adolescents (PAQ-A), self-reported level of gross motor function (based on the Gross Motor Function Classification System [GMFCS]), and specific questions regarding weekly sedentary activities. Following piloting to determine test-retest reliability (intraclass correlation [ICC] for PA=0.90 total weekly sedentary time=0.84) and concurrent validity (survey PA score vs pedometry, Pearson's r=0.24 survey PA score vs accelerometry, r=-0.21 survey weekly sedentary time vs logbook, r=0.38), the survey was mailed to all adolescents with CP in South Australia registered with Novita Children's Services (n=219). One hundred and twelve valid surveys were returned (76 males, 36 females age range 11-17y, mean age 13y 11mo [SD 23mo] GMFCS Level I, n=42 Level II, n=27 Level III, n=10 Level IV, n=17 Level V, n=15 level not reported, n=1). Results were compared with recent normative age- and sex-matched data sets. Key findings were that PA level of adolescents with CP was related to level of gross motor function and inversely related to age, and that adolescents with CP were less physically active than their peers without disability. Comparisons with normative data sets suggested that adolescents with CP tend to participate in less structured and lower intensity PA compared with non-disabled adolescents, though sedentary activity patterns (TV and computer use) of adolescents with and without CP were similar.
Publisher: European Respiratory Society (ERS)
Date: 19-12-2017
DOI: 10.1183/13993003.00773-2016
Abstract: We directly compared convergent, discriminant and concurrent validity of the Dyspnoea-12 (D-12) and Multidimensional Dyspnoea Profile (MDP) in people with chronic obstructive pulmonary disease. Breathlessness measures (D-12, MDP, visual analogue scales and descriptors) were completed for two focal periods (daily life and end of walk test). Instrument structure (D-12 and MDP item grouping) was assessed with factor analysis. Differences between airflow severity stage and focal periods (ANOVA, t-test and Chi-squared test), associations between D-12 and MDP (r, r 2 for static pulmonary function, 6-min walk test and self-reported measures of impairment) and in idual consistency for comparable items of the D-12 and MDP (McNemar's test) were assessed. In 84 participants (mean± sd age 70±9 years, 47 males, forced expiratory volume in 1 s 48±17% predicted), item groupings were confirmed for both focal periods. Developer-recommended single and subdomain scores were highly correlated, and demonstrated similar convergent, discriminant and concurrent validity. In idual consistency differed between the D-12 and MDP according to item/item groups. At the level of developer-recommended single and subdomain scores, the D-12 and MDP share similar psychometric properties, but these instruments serve different purposes, do not assess the same sensations or emotions and are not interchangeable.
Publisher: MDPI AG
Date: 08-06-2023
DOI: 10.3390/HEALTHCARE11121686
Abstract: Chronic breathlessness is a multidimensional, unpleasant symptom common to many health conditions. The Common-Sense Model of Self-Regulation (CSM) was developed to help understand how in iduals make sense of their illness. This model has been underused in the study of breathlessness, especially in considering how information sources are integrated within an in idual’s cognitive and emotional representations of breathlessness. This descriptive qualitative study explored breathlessness beliefs, expectations, and language preferences of people experiencing chronic breathlessness using the CSM. Twenty-one community-dwelling in iduals living with varying levels of breathlessness-related impairment were purposively recruited. Semi-structured interviews were conducted with questions reflecting components of the CSM. Interview transcripts were synthesized using deductive and inductive content analysis. Nineteen analytical categories emerged describing a range of cognitive and emotional breathlessness representations. Representations were developed through participants’ personal experience and information from external sources including health professionals and the internet. Specific words and phrases about breathlessness with helpful or nonhelpful connotations were identified as contributors to breathlessness representations. The CSM aligns with current multidimensional models of breathlessness and provides health professionals with a robust theoretical framework for exploring breathlessness beliefs and expectations.
Publisher: Informa UK Limited
Date: 07-2017
DOI: 10.2147/COPD.S111135
Publisher: SAGE Publications
Date: 24-02-2017
Abstract: Physical activity, sedentary and sleep behaviours have strong associations with health. This systematic review aimed to identify how clinical practice guidelines (CPGs) for the management of chronic obstructive pulmonary disease (COPD) report specific recommendations and strategies for these movement behaviours. A systematic search of databases (Medline, Scopus, CiNAHL, EMbase, Clinical Guideline), reference lists and websites identified current versions of CPGs published since 2005. Specific recommendations and strategies concerning physical activity, sedentary behaviour and sleep were extracted verbatim. The proportions of CPGs providing specific recommendations and strategies were reported. From 2370 citations identified, 35 CPGs were eligible for inclusion. Of these, 21 (60%) provided specific recommendations for physical activity, while none provided specific recommendations for sedentary behaviour or sleep. The most commonly suggested strategies to improve movement behaviours were encouragement from a healthcare provider (physical activity n = 20 sedentary behaviour n = 2) and referral for a diagnostic sleep study (sleep n = 4). Since optimal physical activity, sedentary behaviour and sleep durations and patterns are likely to be associated with mitigating the effects of COPD, as well as with general health and well-being, there is a need for further COPD-specific research, consensus and incorporation of recommendations and strategies into CPGs.
Publisher: Elsevier BV
Date: 07-2017
DOI: 10.1016/J.JPAINSYMMAN.2017.02.015
Abstract: Feasibility and pilot study designs are common in palliative care research. Finding standard guidelines on the structure and reporting of these study types is difficult. In feasibility and pilot studies in palliative care research, to determine 1) how commonly a priori feasibility are criteria reported and whether results are subsequently reported against these criteria? and 2) how commonly are participants' views on acceptability of burden of the study protocol assessed? Four databases (OVID Medline, EMBASE, CINAHL, and PubMed via caresearch.com.au.) were searched. Search terms included palliative care, terminal care, advance care planning, hospice, pilot, feasibility, with a publication date between January 1, 2012 and December 31, 2013. Articles were selected and appraised by two independent reviewers. Fifty-six feasibility and/or pilot studies were included in this review. Only three studies had clear a priori criteria to measure success. Sixteen studies reported participant acceptability or burden with measures. Forty-eight studies concluded feasibility. The terms "feasibility" and "pilot" are used synonymously in palliative care research when describing studies that test for feasibility. Few studies in palliative care research outline clear criteria for success. The assessment of participant acceptability and burden is uncommon. A gold standard for feasibility study design in palliative care research that includes both clear criteria for success and testing of the study protocol for participant acceptability and burden is needed. Such a standard would assist with consistency in the design, conduct and reporting of feasibility and pilot studies.
Publisher: American Academy of Pediatrics (AAP)
Date: 03-2012
Abstract: There is a common belief that children are not getting enough sleep and that children’s total sleep time has been declining. Over the century, many authors have proposed sleep recommendations. The aim of this study was to describe historical trends in recommended and actual sleep durations for children and adolescents, and to explore the rationale of sleep recommendations. A systematic literature review was conducted to identify recommendations for children’s sleep requirements and data reporting children’s actual total sleep time. For each recommendation identified, children’s actual sleep time was determined by identifying studies reporting the sleep duration of children of the same age, gender, and country in the same years. Historical trends in age-adjusted recommended sleep times and trends in children’s actual sleep time were calculated. A thematic analysis was conducted to determine the rationale and evidence-base for recommendations. Thirty-two sets of recommendations were located dating from 1897 to 2009. On average, age-specific recommended sleep decreased at the rate of –0.71 minute per year. This rate of decline was almost identical to the decline in the actual sleep duration of children (–0.73 minute per year). Recommended sleep was consistently ∼37 minutes greater than actual sleep, although both declined over time. A lack of empirical evidence for sleep recommendations was universally acknowledged. Inadequate sleep was seen as a consequence of “modern life,” associated with technologies of the time. No matter how much sleep children are getting, it has always been assumed that they need more.
Publisher: Wiley
Date: 2007
DOI: 10.1002/PRI.389
Publisher: Springer Science and Business Media LLC
Date: 03-10-2011
Publisher: American Academy of Pediatrics (AAP)
Date: 05-2012
Publisher: Springer Science and Business Media LLC
Date: 06-11-2019
DOI: 10.1186/S12913-019-4681-1
Abstract: Consumers frequently access the internet looking for health information. With the growing burden of chronic disease internationally, strategies are focussing on self-management interventions in community and ambulatory settings. The objective of this scoping review was to describe publicly available information on Australian airway clearance services. Publicly funded health services network webpages and Google were systematically searched between July and November 2018 using relevant keywords. We identified the number, location and currency of contact information of services and described the services that were in operation and/or identifiable on the internet. Where specific airway clearance services were not identifiable via searching methods, webpages were navigated for associated physiotherapy services. All identified services were contacted via the listed phone or email to confirm web-based findings. Searching 131 publicly funded health service pages and 191 keyword hits identified four publicly funded airway clearance services (two of which were in operation when confirmed by direct contact) and six private services, all in metropolitan areas of capital cities. Webpages described who their services were for (9/10 services), how to gain referral (4/10) and types of airway clearance techniques available (5/10). A further 286 public physiotherapy services were identified, of which 24 (8%) included descriptors of service provision for respiratory patients on their webpage. In contrast, on direct telephone enquiry airway clearance intervention of some kind was confirmed as being available at 174/286 (61%) sites and unavailable at 69/286 (24%) sites. This scoping review demonstrated inconsistencies between airway clearance service information available on the internet and the reported provision of services confirmed by direct phone contact. Services that are available need to make information visible to consumers on the internet and include details such as referral pathways, interventions and current contact details, to support people with airway clearance problems to access appropriate care in the community.
Publisher: SAGE Publications
Date: 25-04-2013
Publisher: Springer Science and Business Media LLC
Date: 22-12-2010
DOI: 10.1038/NRCARDIO.2009.226
Abstract: In iduals with undetected stable angina pectoris (SAP) as a consequence of undiagnosed coronary artery disease are at high risk of poor quality of life and a premature fatal event (for ex le, sudden cardiac death out of hospital). If the extent and distribution of SAP are accurately identified at the population level, clinical screening could potentially be targeted and evaluated to optimize the management and secondary prevention of underlying coronary artery disease. Common measures of SAP in populations have important limitations. Measures chosen to identify such cases should reflect their validity as measures of undiagnosed SAP, currently symptomatic angina or lifetime diagnosis of angina.
Publisher: Springer Science and Business Media LLC
Date: 25-11-2017
Publisher: BMJ
Date: 14-02-2017
Publisher: PeerJ
Date: 07-07-2021
DOI: 10.7717/PEERJ.11554
Abstract: Blood flow restricted exercise (BFRE) improves physical fitness, with theorized positive effects on vascular function. This systematic review and meta-analysis aimed to report (1) the effects of BFRE on vascular function in adults with or without chronic health conditions, and (2) adverse events and adherence reported for BFRE. Five electronic databases were searched by two researchers independently to identify studies reporting vascular outcomes following BFRE in adults with and without chronic conditions. When sufficient data were provided, meta-analysis and exploratory meta-regression were performed. Twenty-six studies were included in the review (total participants n = 472 n = 41 older adults with chronic conditions). Meta-analysis (k = 9 studies) indicated that compared to exercise without blood flow restriction, resistance training with blood flow restriction resulted in significantly greater effects on endothelial function (SMD 0.76 95% CI [0.36–1.14]). No significant differences were estimated for changes in vascular structure (SMD −0.24 95% CI [−1.08 to 0.59]). In exploratory meta-regression analyses, several experimental protocol factors (design, exercise modality, exercised limbs, intervention length and number of sets per exercise) were significantly associated with the effect size for endothelial function outcomes. Adverse events in BFRE studies were rarely reported. There is limited evidence, predominantly available in healthy young adults, on the effect of BFRE on vascular function. Signals pointing to effect of specific dynamic resistance exercise protocols with blood flow restriction (≥4 weeks with exercises for the upper and lower limbs) on endothelial function warrant further investigation.
Publisher: Elsevier BV
Date: 12-2008
Publisher: Elsevier BV
Date: 02-2005
Publisher: American Institute of Mathematical Sciences (AIMS)
Date: 2016
Publisher: Elsevier BV
Date: 11-2020
Publisher: PeerJ
Date: 27-04-0027
DOI: 10.7717/PEERJ.4604
Abstract: Little is known about how to achieve enduring improvements in physical activity (PA), sedentary behaviour (SB) and sleep for people with chronic obstructive pulmonary disease (COPD). This study aimed to: (1) identify what people with COPD from South Australia and the Netherlands, and experts from COPD- and non-COPD-specific backgrounds considered important to improve behaviours and (2) identify areas of dissonance between these different participant groups. A four-round Delphi study was conducted, analysed separately for each group. Free-text responses (Round 1) were collated into items within themes and rated for importance on a 9-point Likert scale (Rounds 2–3). Items meeting a priori criteria from each group were retained for rating by all groups in Round 4. Items and themes achieving a median Likert score of ≥7 and an interquartile range of ≤2 across all groups at Round 4 were judged important. Analysis of variance with Tukey’s post-hoc tested for statistical differences between groups for importance ratings. Seventy-three participants consented to participate in this study, of which 62 (85%) completed Round 4. In Round 4, 81 items (PA n = 54 SB n = 24 sleep n = 3) and 18 themes (PA n = 9 SB n = 7 sleep n = 2) were considered important across all groups concerning: (1) symptom/disease management, (2) targeting behavioural factors, and (3) less commonly, adapting the social hysical environments. There were few areas of dissonance between groups. Our Delphi participants considered a multifactorial approach to be important to improve PA, SB and sleep. Recognising and addressing factors considered important to recipients and providers of health care may provide a basis for developing behaviour-specific interventions leading to long-term behaviour change in people with COPD.
Publisher: SAGE Publications
Date: 2023
DOI: 10.1177/14799731221150435
Abstract: Physiotherapy-led airway clearance interventions are indicated for some people with chronic lung conditions. This study describes Australian clinical models for the provision of adult airway clearance services. This cross-sectional national study recruited public and private health care providers (excluding cystic fibrosis-specific services) identified by a review of websites. Providers were invited to complete an electronic 61-item survey with questions about airway clearance service context, referral demographics, service provision and program metrics. Data were reported descriptively with differences between metropolitan and non-metropolitan services explored with chi-square tests. Between October-December 2019, the survey was disseminated to 131 providers with 91 responses received (69% response rate 87 (96%) public (34 metropolitan 53 non-metropolitan) and 4 (4%) private). Intent (chronic condition self-management) and types of intervention provided (education, breathing techniques, exercise prescription) were common across all services. Geographic location was associated with differences in airway clearance service models (greater use of regular clinics, telephone/telehealth consultations and dedicated cardiorespiratory physiotherapists in metropolitan locations versus clients incurring service and device provision costs in non-metropolitan regions). While similarities in airway clearance interventions exist, differences in service models may disadvantage people living with chronic lung conditions, especially in non-metropolitan regions of Australia.
Publisher: SAGE Publications
Date: 09-2007
Abstract: A systematic review was performed to identify studies reporting summary data (mean, standard deviation) of sonographic cross-sectional measurements of the ulnar nerve at the elbow. Comparisons of measurements were performed to determine whether statistical differences existed between groups of in iduals symptomatic and asymptomatic of ulnar nerve entrapment at the elbow (UNE). Across the four studies meeting the selection criteria of the search, five s le groups were identified and compared: three asymptomatic of UNE and two symptomatic of UNE. There were significant differences between measurements of people with and without UNE ( P .0001—.041). Significant differences also existed between the two symptomatic populations ( P .0001—.0062) and between the three asymptomatic populations ( P .0001—.41). This systematic review demonstrates that significant differences exist between sonographic measurements of ulnar nerve dimension between people with and without UNE, confirming that these measurements are potential discriminators of UNE. The demonstration of significant differences between measurements of ulnar nerve size within s le populations with similar symptomatic status suggests that further studies are required to confirm the effect of ulnar nerve pathologies, measurement protocols, and anthropometric factors.
Publisher: Informa UK Limited
Date: 11-2021
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 10-2013
DOI: 10.1016/J.JURO.2013.04.076
Abstract: Urinary urgency is an adverse sensory experience. Confirmation of the multidimensional nature of other adverse sensory experiences such as pain and dyspnea has improved the understanding of neurophysiological and perceptual mechanisms leading to innovations in assessment and treatment. It has been suggested that the sensation of urgency may include multiple dimensions such as intensity, suddenness and unpleasantness. In this systematic review we determine which dimensions of sensation have been assessed by instruments used to measure urinary urgency. A systematic search was undertaken of MEDLINE, Embase, AMED, CINAHL, Ageline, Web of Science, InformIT Health and Scopus databases to identify studies that included assessments of urinary urge or urgency. Articles were included in the analysis if they were primary studies that described the method used to measure urge/urgency in adults and published in English in peer reviewed publications since January 1, 2000. Articles were excluded from study if urgency was measured only in conjunction with other symptoms (eg frequency or incontinence) or if there was no English version of the instrument. Secondary analyses and systematic reviews were retained to hand search references for additional primary studies. Data were extracted for the instruments used to measure urge/urgency. For each instrument the items specific to urinary urgency were reviewed using a prospectively developed categorization process for the sensory dimension and the measurement metric. Items used to assess urinary urgency were collated in a matrix (sensory dimensions vs assessment metric). The most frequently used dimensions, metrics and combinations were descriptively analyzed. After removal of duplicate articles 1,048 full text articles were screened and 411 were excluded, leaving 637 eligible articles from which data were extracted. A total of 216 instruments were identified which were 1 of 6 types, namely 1) wider symptom questionnaires, 2) urgency specific questionnaires, 3) ordinal scales, 4) visual analog scales, 5) event records or 6) body maps. These 216 instruments contained a total of 309 urgency specific items. Of the instruments 51% did not define a dimension of sensation and 26% did not define the metric used. From the remaining instruments 8 dimensions of sensation and 5 types of metrics were identified. From most common to least common, the sensory dimensions assessed were behavioral response, intensity, suddenness, bother, affective response, unpleasantness, quality (descriptors) and problems associated with sensation. Metrics were magnitude, frequency, presence, time frame or location. The most common sensory dimension/metric combinations were frequency of a behavioral response (14% of items) and magnitude of bother caused by the sensation (8% of items). The hypothesis that urinary urgency is multidimensional is supported by the range of dimensions assessed with available instruments. To clarify the nature of urinary urgency compared with the normal desire to void, prospective studies are required to determine whether sensory dimensions are distinct, and which may delineate between normal and pathological sensation.
Publisher: Springer Science and Business Media LLC
Date: 24-07-2014
Publisher: Springer Science and Business Media LLC
Date: 30-03-2020
DOI: 10.1186/S12909-020-02006-7
Abstract: Clinicians and people living with chronic breathlessness have expressed a need to better understand and manage this symptom. The aim of this study was to evaluate a 3-day health professional training workshop on the practical management of chronic breathlessness. Workshop design and delivery were based on current understandings and clinical models of chronic breathlessness management, principles of transformative learning, and included sessions co-designed with people living with breathlessness. Registrants were invited to complete pre and post-workshop surveys. Pre and 1-week post-workshop online questionnaires assessed familiarity and confidence about workshop objectives (0[lowest]-10[highest] visual analogue scale), attitudes and practices regarding chronic breathlessness (agreement with statements on 5-point Likert scales). Post-workshop, participants were asked to describe implementation plans and anticipated barriers. Baseline familiarity and confidence were reported as mean (SD) and change examined with paired t-tests. Pre-post attitudes and practices were summarised by frequency ercentages and change examined non-parametrically (5-point Likert scale responses) or using a McNemar test of change (binary responses). Forty-seven of 55 registrants joined the study 39 completed both pre and post-workshop questionnaires (35 female 87% clinicians median 8 years working with people with chronic breathlessness). Post-workshop, greatest gains in confidence were demonstrated for describing biopsychosocial concepts unpinning chronic breathlessness (mean change confidence = 3.2 points 95% CI 2.7 to 4.0, p 0.001). Respondents significantly changed their belief toward agreement that people are able to rate their breathlessness intensity on a scale (60 to 81% agreement) although only a minority strongly agreed with this statement at both time points (pre 11%, post 22%). The largest shift in attitude was toward agreement (z statistic 3.74, p 0.001, effect size r = 0.6) that a person’s experience of breathlessness should be used to guide treatment decisions (from 43 to 73% strong agreement). Participants’ belief that cognitive behavioural strategies are effective for relief of breathlessness changed further toward agreement after the workshop (81 to 100%, McNemar test chi- square = 5.14, p = 0.02). The focus of this training on biopsychosocial understandings of chronic breathlessness and involvement of people living with this symptom were valued. These features were identified as facilitators of change in fundamental attitudes and preparedness for practice.
Publisher: Elsevier BV
Date: 04-2019
DOI: 10.1016/J.JPAINSYMMAN.2019.01.001
Abstract: Chronic breathlessness is a cardinal symptom in cardiopulmonary disease where both overall intensity or severity (S) and unpleasantness (U) are commonly quantified. We aimed to evaluate agreement between breathlessness severity and unpleasantness over eight days in patients with chronic breathlessness. Longitudinal analysis of 265 patients with chronic breathlessness who rated current overall breathlessness severity and unpleasantness on a 0-100 mm visual analogue scale (VAS) in the morning and evening over eight days. A total of 3630 paired overall severity-unpleasantness (S-U) differences were analyzed median 15 (IQR 13-16) per patient. Agreement was evaluated using Bland-Altman plots. Associations of the difference between severity and unpleasantness (S-U difference) with clinical factors and perceived quality of life were analyzed using multilevel linear regression adjusted for confounders. Over eight days, severity and unpleasantness scores were highly correlated, had similar variability, and varied more between patients than within patients. The mean S-U difference was small at 2.1 mm. Agreement between overall severity and unpleasantness was similar or higher than expected from the variability in in idual scores. The S-U difference was similar across evaluated factors including age, sex, diagnosis, morning/evening assessment, modified Medical Research Council breathlessness score, morphine treatment, and presence of different sensory qualities of breathlessness. Higher overall severity and unpleasantness associated with worse perceived quality of life in a similar way. In patients with chronic breathlessness over eight days, overall severity and unpleasantness of breathlessness were comparable and associated to other clinical factors in a similar manner.
Publisher: Elsevier BV
Date: 11-2005
Publisher: Springer Science and Business Media LLC
Date: 10-2020
Abstract: Figure 5b of the paper [1] contained a misinterpretation in the comparison between the reported new ATLAS measurement of the process pp → Xp and previously published CMS data [2]. The ATLAS measurement corresponds to cases where either proton dissociates.
Publisher: Springer Science and Business Media LLC
Date: 31-07-2014
Publisher: Elsevier BV
Date: 02-2012
DOI: 10.1016/J.RMED.2011.10.014
Abstract: What is the best available research evidence (volume, quality, consistency, generalisability) for the active cycle of breathing technique (ACBT)? Systematic review with meta-analysis. Participants with respiratory conditions characterised by chronic sputum production. The active cycle of breathing or forced expiratory technique. COMPARATOR: All comparators including control conditions. All outcomes providing continuous data. Twenty-four studies were included. Ten comparators were identified with the most common being conventional chest physiotherapy, positive expiratory pressure and a control. The outcomes most frequently assessed were sputum wet weight (n = 17), forced vital capacity (n = 12) and forced expiratory volume in 1 s (n = 12). Meta-analysis was completed on the primary outcome of sputum wet weight. The standardised mean difference (SMD, random effects) showed an increase in sputum wet weight during and up to 1 h post ACBT compared to conventional physiotherapy (SMD 0.32, 95%CI 0.05-0.59), external oscillatory devices (0.75, 0.48-1.02), and control (0.24, 0.02-0.46). The overall body of evidence was classified as good (good volume, quality and consistency, excellent generalisability). High level, variable risk of bias research evidence favours ACBT over most alternatives for short-term improvements in secretion clearance.
Publisher: SAGE Publications
Date: 2021
DOI: 10.1177/14799731211056092
Abstract: This descriptive qualitative study explored perspectives of people with chronic obstructive pulmonary disease (COPD) and health professionals concerning blood flow restricted exercise (BFRE) training. People living with COPD and health professionals (exercise physiologists, physiotherapists, and hospital-based respiratory nurses and doctors) participated in interviews or focus groups, which included information about BFRE training and a facilitated discussion of positive aspects, barriers and concerns about BFRE training as a possible exercise-based intervention. Sessions were audio-recorded, and transcript data analysed using inductive content analysis. Thirty-one people participated (people with COPD n = 6 health professionals n = 25). All participant groups expressed positive perceptions of BFRE as a potential alternative low-intensity exercise mode where health benefits might be achieved. Areas of overlap in perceived barriers and concerns included the need to address the risk of potential adverse events, suitability of training sites and identifying processes to appropriately screen potential candidates. While potential benefits were identified, concerns about determining who is safe and suitable to participate, delivery processes, health professional training and effects on a variety of health-related outcomes need to be addressed before implementation of BFRE training for people with COPD.
Publisher: Elsevier BV
Date: 12-2019
Publisher: Springer Science and Business Media LLC
Date: 06-09-2016
Publisher: Springer Science and Business Media LLC
Date: 12-2020
DOI: 10.1140/EPJC/S10052-020-08477-8
Abstract: The jet energy scale, jet energy resolution, and their systematic uncertainties are measured for jets reconstructed with the ATLAS detector in 2012 using proton–proton data produced at a centre-of-mass energy of 8 TeV with an integrated luminosity of $$20 \\, \\hbox {fb}^{-1}$$ 20 fb - 1 . Jets are reconstructed from clusters of energy depositions in the ATLAS calorimeters using the anti- $$k_t$$ k t algorithm. A jet calibration scheme is applied in multiple steps, each addressing specific effects including mitigation of contributions from additional proton–proton collisions, loss of energy in dead material, calorimeter non-compensation, angular biases and other global jet effects. The final calibration step uses several in situ techniques and corrects for residual effects not captured by the initial calibration. These analyses measure both the jet energy scale and resolution by exploiting the transverse momentum balance in $$\\gamma $$ γ + jet, Z + jet, dijet, and multijet events. A statistical combination of these measurements is performed. In the central detector region, the derived calibration has a precision better than 1% for jets with transverse momentum $$150 \\, \\hbox {GeV} p_{{\\mathrm {T}}} $$ 150 GeV p T 1500 GeV, and the relative energy resolution is $$(8.4\\pm 0.6)\\%$$ ( 8.4 ± 0.6 ) % for $$p_{{\\mathrm {T}}}= 100 \\, \\hbox {GeV}$$ p T = 100 GeV and $$(23\\pm 2)\\%$$ ( 23 ± 2 ) % for $$p_{{\\mathrm {T}}}= 20 \\, \\hbox {GeV}$$ p T = 20 GeV . The calibration scheme for jets with radius parameter $$R=1.0$$ R = 1.0 , for which jets receive a dedicated calibration of the jet mass, is also discussed.
Publisher: Informa UK Limited
Date: 04-2020
DOI: 10.2147/COPD.S178049
Publisher: SAGE Publications
Date: 2022
DOI: 10.1177/14799731221105518
Abstract: Dyspnoea and pain are symptoms of chronic obstructive pulmonary disease (COPD). This review focused upon pain and dyspnoea during hospital admissions for acute exacerbations of COPD (AECOPD), with the aim of examining prevalence, assessment, clinical associations, and researcher-reported implications of these symptoms. Four electronic databases were searched from inception to 31 May 2021. Full text versions of studies were assessed for methodological quality and data were extracted independently by two reviewers. Where data permitted, pooled prevalence of pain and dyspnoea were calculated by meta-analysis. Four studies were included. The pooled prevalence of pain and dyspnoea was 44% (95% confidence interval (CI) 35%–52%) and 91% (95% CI 87%–94%) respectively. An array of instruments with varying focal periods were reported (pain: six tools, dyspnoea: four tools). Associations and clinical implications between the two symptoms at the time of hospital admission were rarely reported. Few studies reported prevalence of pain and dyspnoea during an AECOPD. A greater understanding into the prevalence, intensity and associations of these symptoms during AECOPD could be furthered by use of standardised assessment tools with clearly defined focal periods.
Publisher: Elsevier BV
Date: 11-2004
Publisher: Wiley
Date: 23-07-2007
DOI: 10.1111/J.1440-1843.2007.01120.X
Abstract: The fifteen-count breathlessness score (15CBS) has been reported to quantify breathlessness however, a ceiling effect limits its ability to discriminate between subjects with varying degrees of breathlessness. The aim of this study was to determine the reliability, sensitivity, specificity and validity of the thirty-count breathlessness score (30CBS) in adults with COPD. Using an observational correlation design, subjects with clinical signs and symptoms of COPD were videotaped performing the 30CBS on two occasions. Respiratory related quality of life questionnaires, self-report shortness breathlessness measures and pulmonary function tests were completed by all subjects. Asymptomatic subjects of a similar age completed the 30CBS for comparison. Thirty-eight COPD subjects and 24 control subjects completed the protocol. The 30CBS was reliable within and between assessors (intraclass correlation coefficients >0.7). The 30CBS demonstrated a higher sensitivity (55.8% sensitivity, 82.3% specificity) than the 15CBS (33.2% sensitivity, 93.2% specificity) however, the sensitivity of the 30CBS was still not great enough to discriminate between those with and without COPD. Regression analysis calculated significant relationships between the 30CBS and a majority of measures of pulmonary impairment (flows and volumes), age, height, Visual Analogue Scale for breathlessness and physical aspects of the Short Form-36. While reliable, the 30CBS did not display sufficient discriminative ability to predict subjects with COPD though subjects requiring greater than two breaths may warrant further investigation. The 30CBS may be a useful indicator of physiological impairment, but was not significantly correlated with measures of breathlessness.
Publisher: Elsevier BV
Date: 06-2019
DOI: 10.1016/J.PHRS.2019.04.020
Abstract: Resveratrol (RSV) has been reported to have potential beneficial effects in the complicated pregnancy. Various pregnancy complications lead to a suboptimal in utero environment that impacts fetal growth during critical windows of development. Detrimental structural changes to key organ systems in utero persist into adult life and predispose offspring to an increased risk of chronic non-communicable metabolic diseases such as cardiovascular disease, diabetes and obesity. The aim of this systematic review was to determine the effect of gestational RSV exposure on both maternal and fetal outcomes. Publicly available databases (n = 8) were searched for original studies reporting maternal and/or fetal outcomes after RSV exposure during pregnancy irrespective of species. Of the 115 studies screened, 31 studies were included in this review. RSV exposure occurred for different durations across a range of species (Rats n = 18, Mice n = 7, Japanese Macaques n = 3 and Sheep n = 3), models of complicated pregnancy (eg. maternal dietary manipulations, gestational diabetes, maternal hypoxia, teratogen exposure, etc.), dosages and administration routes. Maternal and fetal outcomes differed not only based on the model of complicated pregnancy assessed but also as a result of species. Given the heterogenic nature of these studies, further investigation assessing RSV exposure during the complicated pregnancy is warranted. In order to make an informed decision regarding the use of RSV to intervene in pregnancy complications, we suggest a minimum data set for consideration in future studies.
Publisher: MDPI AG
Date: 22-01-2019
DOI: 10.3390/HEALTHCARE7010015
Abstract: Chronic pain is highly prevalent and more common in people with chronic obstructive pulmonary disease (COPD) than people of similar age/sex in the general population. This systematic review aimed to describe how frequently and in which contexts pain is considered in the clinical practice guidelines (CPGs) for the broad management of COPD. Databases (Medline, Scopus, CiNAHL, EMbase, and clinical guideline) and websites were searched to identify current versions of COPD CPGs published in any language since 2006. Data on the frequency, context, and specific recommendations or strategies for the assessment or management of pain were extracted, collated, and reported descriptively. Of the 41 CPGs (English n = 20) reviewed, 16 (39%) did not mention pain. Within the remaining 25 CPGs, pain was mentioned 67 times (ranging from 1 to 10 mentions in a single CPG). The most frequent contexts for mentioning pain were as a potential side effect of specific pharmacotherapies (22 mentions in 13 CPGs), as part of differential diagnosis (14 mentions in 10 CPGs), and end of life or palliative care management (7 mentions in 6 CPGs). In people with COPD, chronic pain is common adversely impacts quality of life, mood, breathlessness, and participation in activities of daily living and warrants consideration within CPGs for COPD.
Publisher: Springer Science and Business Media LLC
Date: 10-2020
DOI: 10.1140/EPJC/S10052-020-8227-9
Abstract: Higgs boson properties are studied in the four-lepton decay channel (where lepton = e , $$\\mu $$ μ ) using 139 $$\\hbox {fb}^{-1}$$ fb - 1 of proton–proton collision data recorded at $$\\sqrt{s}=$$ s = 13 TeV by the ATLAS experiment at the Large Hadron Collider. The inclusive cross-section times branching ratio for $$H\\rightarrow ZZ^*$$ H → Z Z ∗ decay is measured to be $$1.34 \\pm 0.12$$ 1.34 ± 0.12 pb for a Higgs boson with absolute rapidity below 2.5, in good agreement with the Standard Model prediction of $$1.33 \\pm 0.08$$ 1.33 ± 0.08 pb. Cross-sections times branching ratio are measured for the main Higgs boson production modes in several exclusive phase-space regions. The measurements are interpreted in terms of coupling modifiers and of the tensor structure of Higgs boson interactions using an effective field theory approach. Exclusion limits are set on the CP-even and CP-odd ‘beyond the Standard Model’ couplings of the Higgs boson to vector bosons, gluons and top quarks.
Publisher: Springer Science and Business Media LLC
Date: 07-2020
DOI: 10.1140/EPJC/S10052-020-8001-Z
Abstract: This paper describes precision measurements of the transverse momentum $$p_\\mathrm {T}^{\\ell \\ell }$$ p T ℓ ℓ ( $$\\ell =e,\\mu $$ ℓ = e , μ ) and of the angular variable $$\\phi ^{*}_{\\eta }$$ ϕ η ∗ distributions of Drell–Yan lepton pairs in a mass range of 66–116 GeV. The analysis uses data from 36.1 fb $$^{-1}$$ - 1 of proton–proton collisions at a centre-of-mass energy of $$\\sqrt{s}=13\\,$$ s = 13 TeV collected by the ATLAS experiment at the LHC in 2015 and 2016. Measurements in electron-pair and muon-pair final states are performed in the same fiducial volumes, corrected for detector effects, and combined. Compared to previous measurements in proton–proton collisions at $$\\sqrt{s}=7$$ s = 7 and $$8\\,$$ 8 TeV, these new measurements probe perturbative QCD at a higher centre-of-mass energy with a different composition of initial states. They reach a precision of 0.2 $$\\%$$ % for the normalized spectra at low values of $$p_\\mathrm {T}^{\\ell \\ell }$$ p T ℓ ℓ . The data are compared with different QCD predictions, where it is found that predictions based on resummation approaches can describe the full spectrum within uncertainties.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 09-2019
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 09-10-2023
Publisher: PeerJ
Date: 31-07-2018
DOI: 10.7717/PEERJ.5318
Abstract: Blinding is critical to clinical trials because it allows for separation of specific intervention effects from bias, by equalising all factors between groups except for the proposed mechanism of action. Absent or inadequate blinding in clinical trials has consistently been shown in large meta-analyses to result in overestimation of intervention effects. Blinding in dry needling trials, particularly blinding of participants and therapists, is a practical challenge therefore, specific effects of dry needling have yet to be determined. Despite this, dry needling is widely used by health practitioners internationally for the treatment of pain. This review presents the first empirical account of the influence of blinding on intervention effect estimates in dry needling trials. The aim of this systematic review was to determine whether participant beliefs about group allocation relative to actual allocation (blinding effectiveness), and/or adequacy of blinding procedures, moderated pain outcomes in dry needling trials. Twelve databases (MEDLINE, EMBASE, AMED, Scopus, CINAHL, PEDro, The Cochrane Library, Trove, ProQuest, trial registries) were searched from inception to February 2016. Trials that compared active dry needling with a sham that simulated dry needling were included. Two independent reviewers performed screening, data extraction, and critical appraisal. Available blinding effectiveness data were converted to a blinding index, a quantitative measurement of blinding, and meta-regression was used to investigate the influence of the blinding index on pain. Adequacy of blinding procedures was based on critical appraisal, and subgroup meta-analyses were used to investigate the influence of blinding adequacy on pain. Meta-analytical techniques used inverse-variance random-effects models. The search identified 4,894 in idual publications with 24 eligible for inclusion in the quantitative syntheses. In 19 trials risk of methodological bias was high or unclear. Five trials were adequately blinded, and blinding was assessed and sufficiently reported to compute the blinding index in 10 trials. There was no evidence of a moderating effect of blinding index on pain. For short-term and long-term pain assessments pooled effects for inadequately blinded trials were statistically significant in favour of active dry needling, whereas there was no evidence of a difference between active and sham groups for adequately blinded trials. The small number and size of included trials meant there was insufficient evidence to conclusively determine if a moderating effect of blinding effectiveness or adequacy existed. However, with the caveats of small s le size, generally unclear risk of bias, statistical heterogeneity, potential publication bias, and the limitations of subgroup analyses, the available evidence suggests that inadequate blinding procedures could lead to exaggerated intervention effects in dry needling trials.
Publisher: American Physical Society (APS)
Date: 21-09-2020
Publisher: Public Library of Science (PLoS)
Date: 27-11-2013
Publisher: Elsevier BV
Date: 07-2018
Publisher: Springer Science and Business Media LLC
Date: 25-01-2013
Publisher: Springer Science and Business Media LLC
Date: 12-10-2010
Publisher: Oxford University Press (OUP)
Date: 04-2013
DOI: 10.5665/SLEEP.2538
Publisher: Elsevier BV
Date: 2022
DOI: 10.1016/J.JPAINSYMMAN.2021.06.023
Abstract: The Dyspnoea-12 (D-12) and Multidimensional Dyspnea Profile (MDP) were specifically developed for assessment of multiple sensations of breathlessness. This systematic review aimed to identify the use and measurement properties of the D-12 and MDP across populations, settings and languages. Electronic databases were searched for primary studies (2008-2020) reporting use of the D-12 or MDP in adults. Two independent reviewers completed screening and data extraction. Study and participant characteristics, instrument use, reported scores and minimal clinical important differences (MCID) were evaluated. Data on internal consistency (Cronbach's α) and test-retest reliability (intraclass correlation coefficient, ICC) were pooled using random effects models between settings and languages. A total 75 publications reported use of D-12 (n = 35), MDP (n = 37) or both (n = 3), reflecting 16 chronic conditions. Synthesis confirmed two factor structure, internal consistency (Cronbach's α mean, 95% CI: D-12 Total = 0.93, 0.91-0.94 MDP Immediate Perception [IP] = 0.88, 0.85-0.90 MDP Emotional Response [ER] = 0.86, 0.82-0.89) and 14 day test-rest reliability (ICC: D-12 Total = 0.91, 0.88-0.94 MDP IP = 0.85, 0.70-0.93 MDP ER = 0.84, 0.73-0.90) across settings and languages. MCID estimates for clinical interventions ranged between -3 and -6 points (D-12 Total) with small variability in scores over 2 weeks (D-12 Total 2.8 (95% CI: 2.0 to 3.7), MDP-A1 0.8 (0.6 to 1.1) and six months (D-12 Total 2.9 (2.0 to 3.7), MDP-A1 0.8 (0.6 to 1.1)). D-12 and MDP are widely used, reliable, valid and responsive across various chronic conditions, settings and languages, and could be considered standard instruments for measuring dimensions of breathlessness in international trials.
Publisher: Elsevier BV
Date: 02-2007
Publisher: Royal Society of Chemistry (RSC)
Date: 2014
DOI: 10.1039/C3OB42332H
Abstract: A fluorescent α 9 β 1 integrin antagonist with nanomolar binding affinities has been demonstrated to bind bone marrow haemopoietic stem and progenitor cells in vivo .
Publisher: JMIR Publications Inc.
Date: 12-11-2019
Abstract: obile ecological momentary assessment (mEMA) permits real-time capture of self-reported participant behaviors and perceptual experiences. Reporting of mEMA protocols and compliance has been identified as problematic within systematic reviews of children, youth, and specific clinical populations of adults. his study aimed to describe the use of mEMA for self-reported behaviors and psychological constructs, mEMA protocol and compliance reporting, and associations between key components of mEMA protocols and compliance in studies of nonclinical and clinical s les of adults. n total, 9 electronic databases were searched (2006-2016) for observational studies reporting compliance to mEMA for health-related data from adults (& years) in nonclinical and clinical settings. Screening and data extraction were undertaken by independent reviewers, with discrepancies resolved by consensus. Narrative synthesis described participants, mEMA target, protocol, and compliance. Random effects meta-analysis explored factors associated with cohort compliance (monitoring duration, daily prompt frequency or schedule, device type, training, incentives, and burden score). Random effects analysis of variance ( i P /i ≤.05) assessed differences between nonclinical and clinical data sets. f the 168 eligible studies, 97/105 (57.7%) reported compliance in unique data sets (nonclinical=64/105 [61%], clinical=41/105 [39%]). The most common self-reported mEMA target was affect (primary target: 31/105, 29.5% data sets secondary target: 50/105, 47.6% data sets). The median duration of the mEMA protocol was 7 days (nonclinical=7, clinical=12). Most protocols used a single time-based (random or interval) prompt type (69/105, 65.7%) median prompt frequency was 5 per day. The median number of items per prompt was similar for nonclinical (8) and clinical data sets (10). More than half of the data sets reported mEMA training (84/105, 80%) and provision of participant incentives (66/105, 62.9%). Less than half of the data sets reported number of prompts delivered (22/105, 21%), answered (43/105, 41%), criterion for valid mEMA data (37/105, 35.2%), or response latency (38/105, 36.2%). Meta-analysis (nonclinical=41, clinical=27) estimated an overall compliance of 81.9% (95% CI 79.1-84.4), with no significant difference between nonclinical and clinical data sets or estimates before or after data exclusions. Compliance was associated with prompts per day and items per prompt for nonclinical data sets. Although widespread heterogeneity existed across analysis (I sup /sup & %), no compelling relationship was identified between key features of mEMA protocols representing burden and mEMA compliance. n this 10-year s le of studies using the mEMA of self-reported health-related behaviors and psychological constructs in adult nonclinical and clinical populations, mEMA was applied across contexts and health conditions and to collect a range of health-related data. There was inconsistent reporting of compliance and key features within protocols, which limited the ability to confidently identify components of mEMA schedules likely to have a specific impact on compliance.
Publisher: Informa UK Limited
Date: 12-2014
DOI: 10.2147/COPD.S74298
Publisher: SAGE Publications
Date: 07-2001
DOI: 10.1177/87564790122250453
Abstract: Various sonography studies have evaluated the normal flexor tendons of the fingers by reporting the echogenicity of these structures. Due to the descriptive nature of these studies, little information is available concerning the reproducibility of sonographic measures of the finger flexor tendons. The aim of this study was to determine whether sonography measurement of finger flexor tendons can provide reproducible information. The study used a test-retest, same-subject experimental design. In iduals who had no history of injury or surgery to the fingers had the right and left middle fingers of both hands assessed on two different occasions (test 1 and test 2) separated by at least 4 hours. The flexor tendons were assessed for continuity and measured for thickness at three points along the finger: the heads of the metacarpal, proximal phalanx, and middle phalanx. Reliability was assessed using Pearson's Correlation Coefficient ( r), t test (paired two-tail), and the intraclass correlation coefficient (ICC 1,1 ). The majority of measures had an excellent linear correlation ( r 0.75). The t tests indicated that there were no significant differences between the two tests ( P [.lessequal] .05). High ICC 1,1 values suggested that there were excellent relationships between the measures on the two occasions of testing. No significant differences were found between measures of the left and right hands. The synovial sheath-pulley systems were evident as an echogenic specular reflection situated anteriorly to the flexor tendons in all in iduals. Using this measurement protocol, sonography was found to be a reliable method of measuring and assessing the flexor tendons of the fingers.
Publisher: Oxford University Press (OUP)
Date: 04-2012
DOI: 10.2522/PTJ.20110013
Abstract: The generation of research can be likened to the production of consumer goods, with a producer (the study authors and funders), a product (the study and publications arising from it), and consumers (those who read and cite the published study). The aim of this study was to use bibliometric indexes to track changes in the producers, products, and consumers of the journal Physical Therapy from 1945 through 2010. An analysis of published manuscripts (excluding letters, editorials, corrections, commentaries, and book reviews) in Physical Therapy was performed using a reliable bibliometric audit tool. Articles were s led every 3 months and at 5-year intervals over a 65-year period. Information relating to authorship, the research methods used, and citation patterns was collected. Data were analyzed descriptively. There have been substantial shifts in the nature of research published over the last 65 years in Physical Therapy. In 1945, the typical paper was anecdotal and authored by 1.4 American authors (working in hospitals), and consisted of 4 pages and 4 references. In 2010, the typical paper used a cross-sectional survey or randomized controlled trial design, with 4.6 multinational authors (working in universities), and consisted of 12 pages and 49 references. Findings are specific to the articles published in Physical Therapy that were s led in this bibliometric analysis. The changes seen in the research published in Physical Therapy mirror the shifts that have occurred in other industries: increasing quantification, standardization, collaboration, and internationalization. These trends are likely to continue in the future.
Publisher: Public Library of Science (PLoS)
Date: 21-03-2019
Publisher: SAGE Publications
Date: 10-03-2020
Abstract: In clinical trials of physical interventions, participant blinding is often poorly addressed and therapist blinding routinely omitted. This situation presents a substantial barrier to moving the field forward. Improving the success of blinding will be a vital step towards determining the true mechanisms of physical interventions. We used a Delphi approach to identify important elements of shams for physical interventions to maximise the likelihood of participant and therapist blinding in clinical trials. Two expert groups were recruited: (1) experts in research methodology and (2) experts in deceptive and/or hypnotic techniques including magic. Magicians were included because they were considered a potentially rich source of innovation for developing credible shams due to their unique skills in altering perceptions and beliefs. Three rounds of survey were conducted, commencing with an open-ended question. Responses were converted to single ‘items’, which participants rated in the following two rounds using a 9-point Likert scale, categorised as ‘Not important’ (0–3), ‘Depends’ (4–6) and ‘Essential’ (7–9). Consensus was pre-defined as ≥80% agreement within a 3-point category. Thirty-eight experts agreed to participate (research methodology: n = 22 deceptive and/or hypnotic techniques: n = 16), and 30 experts responded to at least one round (research methodology: n = 19 deceptive and/or hypnotic techniques: n = 11). Of 79 items, five reached consensus in the ‘Essential’ category in both groups, which related to beliefs of participants ( n = 3 items), interactions with researchers ( n = 1 item) and standardisation of clinical assessments ( n = 1 item). Thirteen additional items reached consensus in the ‘Essential’ category in one group. Experts in research methodology had one additional item reach consensus, related to authentic delivery of study information. The remaining 12 additional items that reached consensus in the deceptive and/or hypnotic techniques group related mainly to therapist attitude and behaviour and the clinical interaction. Experts agreed that, for shams to be believable, consideration of cognitive influences is essential. Contrary to the focus of previous shams for physical interventions, replicating the tactile sensation of the active treatment was not considered an essential part of sham development. Therefore, when designing sham-controlled clinical trials, researchers should carefully consider the cognitive credibility of the entire intervention experience, and not just the indistinguishability of the sham intervention itself. The findings provide new guidance to researchers on important contributors to blinding in physical intervention trials.
Publisher: Springer Science and Business Media LLC
Date: 09-2020
Abstract: Inclusive and differential cross-sections for the production of top quarks in association with a photon are measured with proton-proton collision data corresponding to an integrated luminosity of 139 fb − 1 . The data were collected by the ATLAS detector at the LHC during Run 2 between 2015 and 2018 at a centre-of-mass energy of 13 TeV. The measurements are performed in a fiducial volume defined at parton level. Events with exactly one photon, one electron and one muon of opposite sign, and at least two jets, of which at least one is b -tagged, are selected. The fiducial cross-section is measured to be $$ {39.6}_{-2.3}^{+2.7} $$ 39.6 − 2.3 + 2.7 fb. Differential cross-sections as functions of several observables are compared with state-of-the-art Monte Carlo simulations and next-to-leading-order theoretical calculations. These include cross-sections as functions of photon kinematic variables, angular variables related to the photon and the leptons, and angular separations between the two leptons in the event. All measurements are in agreement with the predictions from the Standard Model.
Publisher: European Respiratory Society (ERS)
Date: 2020
DOI: 10.1183/23120541.00343-2019
Abstract: Few studies have examined the contribution of life-course factors in explaining familial aggregation of chronic lung conditions. Using data from the 1958 British Birth Cohort, a life-course approach was used to examine whether, and how, exposure to risk factors through one's life explained the association between parental respiratory disease history and symptomatic airflow obstruction (AO). Cohort participants (n=6212) were characterised in terms of parental respiratory disease history and symptomatic AO at 45 years. Life-course factors ( e.g. smoking, asthma and early-life factors) were operationalised as life period-specific and cumulative measures. Logistic regression and path analytic models predicting symptomatic AO adjusted for parental respiratory disease history were used to test different life-course models (critical period, accumulation- and chain-of-risks models). While some life-course factors ( e.g. childhood passive smoking and occupational exposure) were in idually associated with parental respiratory disease history and symptomatic AO, asthma (OR 6.44, 95% CI 5.01–8.27) and persistent smoking in adulthood (OR 5.42, 95% CI 4.19–7.01) had greater impact on the association between parental respiratory disease history and symptomatic AO. A critical period model provided a better model fit compared with an accumulation-of-risk model and explained 57% of the effect of parental respiratory disease history on symptomatic AO. Adulthood asthma and smoking status explained around half of the effect of parental respiratory disease history on chronic obstructive pulmonary disease. Beyond smoking history, the combination of parental respiratory disease history and adulthood asthma may provide an opportunity for early diagnosis and intervention.
Publisher: Springer Science and Business Media LLC
Date: 11-2020
Publisher: Elsevier BV
Date: 2009
DOI: 10.1016/J.APERGO.2008.01.016
Abstract: Vertical spinal creep (VSC) is height loss during sustained postures over a set period of time. While total stature has been demonstrated to decrease throughout the day, whether a diurnal effect applies to the VSC response has not been reported. The aim of this study was to investigate whether time of day had an effect on the magnitude of the VSC response in young subjects asymptomatic for musculoskeletal pathologies. The VSC response was recorded over 25 min while subjects remained seated on the stadiometer, at three times (morning, midday and afternoon) on the same day, in 48 asymptomatic volunteers aged 20-39 years. While no significant differences were calculated for the magnitude of the VSC responses on the three occasions of testing, differences in magnitude of VSC response may have been confounded by preloading activities. Where magnitude of the VSC response is the primary outcome measure, measurement protocols should control preloading activities and continue to conduct measurements at the same time of day, until further studies conclusively refute the existence of a diurnal effect.
Publisher: SAGE Publications
Date: 08-2019
Abstract: To date, time-use studies in palliative care have been limited to exploration of time commitments of caregivers. Understanding time-use in people with a life-limiting illness might provide insight into disease progression, symptom management and quality of life. To determine the feasibility of a repeated-measures, time-use study in people with a life-limiting illness, and their primary caregivers, and to explore associations between time-use and perceived quality of life. An observational repeated-measures feasibility pilot study. A priori criteria were established for study uptake (70%), retention (80%) and study value/burden (⩾7 Numerical Rating Scale 0–10). Burden and value of the study, use of time (Multimedia Activity Recall for Children and Adults with adjunctive accelerometry) and quality of life data (EuroQol-5 Dimension-5-Level Health Questionnaire and Australia-modified Karnofsky Performance Status scale) were assessed at time-points across five consecutive months. People living with a life-limiting illness and caregivers recruited from Southern Adelaide Palliative Services outpatient clinics. A total of 10 participants (2 caregivers and 8 people with a life-limiting illness) enrolled in the study. All but one of the criteria thresholds was met: 66% of participants who consented to be screened were enrolled in the study, 80% of enrolled participants ( n = 8) completed all assessments (two participants died during the study) and mean Numerical Rating Scale scores for acceptable burden and value of the study exceeded the criteria thresholds at every time-point. A repeated-measures time-use study design is feasible and was not unduly burdensome for caregivers and people living with a life-limiting illness.
Publisher: Elsevier BV
Date: 03-2020
Publisher: American Physical Society (APS)
Date: 04-06-2020
Publisher: MDPI AG
Date: 11-02-2015
Publisher: Cambridge University Press (CUP)
Date: 21-01-2018
DOI: 10.1017/S1478951517001122
Abstract: Although the needs of the bereaved have been identified widely in the literature, how these needs translate into meaningful, appropriate, and client-centered programs needs further exploration. The application of receptivity to support is a critical factor in participation by the bereaved in palliative care bereavement programs. Receptivity is a complex multifactorial phenomenon influenced by internal and external factors that ultimately influences engagement in psychosocial support in bereavement. This study explored factors that influence receptivity to bereavement support from palliative care services in rural, regional, and remote Western Australia. The study comprised a qualitative descriptive research design using semistructured interviews with 24 bereaved in iduals, nine palliative care health professionals, and four Aboriginal Health Professionals. Participants were recruited via palliative care services in country Western Australia. Interviews were transcribed verbatim and thematically analyzed. Findings revealed that a range of in idual, social, and geographical factors influence receptivity to bereavement support and can impact on utilization of bereavement support services. Receptivity provides a frame of reference to enhance understanding of factors influencing engagement in psychosocial support in bereavement. Receptivity promotes a shift of service provider perspectives of effective supportive care to consumer-centric reasons for engagement.
Publisher: Springer Science and Business Media LLC
Date: 24-04-2013
DOI: 10.1038/IJO.2012.49
Abstract: Breathlessness on exertion is common in people with obesity. Assessments of breathlessness may include sensation (intensity, sensory quality or unpleasantness) and/ or the behavioral/emotional consequences of the sensation (respiratory-related functional impairment, disability or quality of life). This systematic review of primary studies published since 2005 evaluated how has the sensation of breathlessness been assessed in adults with increased adiposity. A total of 41 articles were retained from the systematic search strategy resulting in 20 instruments. The Modified Borg Scale (perceived exertion-intensity), the Medical Research Council (MRC) Scale and Baseline Dyspnea Index (BDI both assess respiratory-related functional impairment) were, respectively, the most frequently reported instruments. Few instruments had been tested for reliability and validity in people with increased adiposity. Visual Analog Scale, Modified Borg Scale, descriptors of sensory quality, MRC and BDI can be recommended as instruments based on their psychometric properties (reliability (correlations >0.8) and concurrent validity (correlation with severity of airways obstruction and walking distance)). A greater number of instruments were identified that assessed the consequences of the breathlessness rather than breathlessness as a sensation. If sensation drives behavior, comprehensive data on the sensation of breathlessness might assist in understanding the behavioral consequences of interventions.
Publisher: Elsevier BV
Date: 12-2021
DOI: 10.1016/J.PHYSIO.2021.08.004
Abstract: Complex physical interventions are widely used in physiotherapy, despite doubts over the validity of clinical trial results due to lack of credible shams. Credible shams are critically needed, so too, therefore, is a process by which they can be developed. The authors used a novel methodology to develop and test blinding protocols for dry needling, a complex physical intervention for which blinding is particularly difficult. The research design was a practical three-day workshop influenced by Participatory Action Research, which uses iteration and reflection to solve a problem. Five multidisciplinary experts (researchers, clinicians, technician, magician) were invited. Healthy volunteers ('recipients', n=17) and accredited physiotherapists (n=6) were recruited to enable testing of blinding strategies. Primary outcomes were expert opinion on the potential to blind recipients/therapists for (1) in idual blinding strategies, and (2) entire blinding protocols. Secondary outcomes included recipient/therapist blinding effectiveness and acceptability. Experts iteratively developed 11 blinding protocols involving 22 blinding strategies. Experts rated 18 of the blinding strategies to 'definitely have potential' and identified four categories: knowledge of the sham, clinical interaction, disinformation, and sensation. Recipient and therapist blinding became more successful as the protocols evolved. Credible shams capable of simultaneous recipient and therapist blinding have been regarded to be impossible in dry needling. The preliminary success of the devised protocols suggest that our novel approach may be a crucial step in sham development. Improvements in expert rankings and blinding effectiveness as the protocols progressed support the value of this workshop approach.
Publisher: MDPI AG
Date: 16-03-2018
Abstract: Descriptions of time use patterns in people with chronic obstructive pulmonary disease (COPD) are scarce and the relationship between use-of-time and COPD severity remains unclear. This study aimed to describe a typical day for people with COPD and to explore the differences in time-use patterns across the Body Mass-Index, Airflow Obstruction, Dyspnoea and Exercise Capacity (BODE) index using compositional analyses. Using a cross-sectional design, 141 adults with clinically stable COPD had their demographics, objective measures of function (pulmonary, exercise capacity and physical activity), and self-reported COPD-related impairment recorded. Daily time-use compositions were derived from 24-h accelerometry and 24-h use-of-time recall interviews. Compositional multiple linear regression models were used to explore the relationship between the BODE index and 24-h time-use compositions. These models were used to predict daily time (min/d) that is spent in time-use components across the BODE index. The BODE index score was clearly associated with 24-h accelerometry (p 0.0001) and 24-h use-of-time recall (p 0.0001) compositions. Relative to the remaining time-use components, higher BODE index scores were associated with greater sedentary behaviour (p 0.0001), Quiet time (p 0.0001), Screen time (p = 0.001) and Self-care (p = 0.022), and less daily Chores (p 0.0001) and Household administration (p = 0.015) time. As the BODE index scores increased, time-use predictions were strongly associated with decreases in Chores (up to 206 min/d), and increases in Screen (up to 156 min/d) and Quiet time (up to 131 min/d). Time–use patterns may provide a basis for planning interventions relative to the severity of COPD.
Publisher: Elsevier BV
Date: 12-2021
DOI: 10.1016/J.PHYSIO.2021.08.007
Abstract: Dry needling is widely used in physiotherapy. Lack of blinding in clinical trials means that dry needling effects and mechanisms remain unclear, with blinding issues accepted as an unavoidable barrier to better evidence. The authors aimed to overcome this barrier by designing a protocol to double-blind dry needling trials. A prospectively registered randomised experiment tested a novel blinding protocol for blinding effectiveness. University physiotherapy clinic. Therapists (n=15) and asymptomatic volunteers ('recipients') (n=45) were randomly allocated to real and/or sham interventions. The protocol involved custom-made needles and cognitive and multisensory blinding techniques. The primary outcome was guesses about allocation. The a priori criterion for successful blinding was ≤50% correct guesses (random chance). Secondary analyses explored blinding patterns using blinding indices. Correct guesses were not different from 50% for therapists [41% (95%CI 30 to 50), n=120 guesses] or recipients [49% (95%CI 38 to 60), n=90 guesses]. Blinding indices supported the primary result but revealed that recipients were better at detecting real dry needling than sham. Both therapists and recipients were successfully blinded, which contrasts with the widely held assumption that double-blinding is impossible for needling interventions. The authors recommend that any future trials can, and therefore should, blind therapists. However, secondary analyses revealed that recipients receiving real dry needling were less blinded than sham recipients, which may still create bias in clinical trials and suggests further work is needed to improve recipient blinding. Nonetheless, the current findings offer an opportunity to gain better evidence concerning the effects and mechanisms of dry needling. osf.io/rkzeb/.
Publisher: Springer Science and Business Media LLC
Date: 05-05-2021
DOI: 10.1038/S41533-021-00232-0
Abstract: During the COVID-19 pandemic, semi-structured interviews were undertaken with 20 adults awaiting a diagnosis for their chronic breathlessness. Three key themes were identified using thematic analysis: (1) de-prioritisation of diagnosis, (2) following UK ‘lockdown’ guidance for the general population but patients fearful they were more at risk, and (3) the impact of lockdown on coping strategies for managing breathlessness. The existing unpredictable pathway to diagnosis for those with chronic breathlessness has been further interrupted during the COVID-19 pandemic.
Publisher: Elsevier BV
Date: 08-2020
Publisher: Informa UK Limited
Date: 2009
DOI: 10.3109/09593980802665023
Abstract: Novel, short-lived upper limb tasks performed by young adults have been used to investigate the role of transversus abdominis (TrA) in maintaining postural stability. Little information exists concerning the behaviour of TrA in older adults during protracted postural challenges. The primary aim of this study was to describe the change in thickness of TrA during an incremental upper limb exercise test in older adults. A secondary analysis was undertaken to compare the results between younger and older subjects. Healthy subjects aged between 40 and 70 years performed the Unsupported Upper Limb Exercise Test (UULEX) while activity of TrA was continuously monitored by using rehabilitative ultrasound imaging. Changes in muscle dimensions were measured every minute during the test. The thickness of TrA increased significantly and exponentially between minutes 8 and 13 of the UULEX. Although there was a significant difference between older and younger subjects in absolute measures of TrA thickness, the change in TrA thickness as a percentage of resting thickness during the UULEX demonstrated an identical pattern between younger and older subjects. This study suggests that TrA is continually and increasingly active during an upper limb task in both younger and older asymptomatic subjects.
Publisher: Wiley
Date: 24-03-2014
DOI: 10.1002/NAU.22587
Abstract: To determine whether the multidimensional sensation of desire to void can be reliability assessed and whether differences exist between people with and without overactive bladder (OAB). Assessing reliability and convergent validity of OAB screening tools comprised a secondary aim. This observational, repeated-measures study involved 64 volunteers (47 female), aged ≥50 years, with and without OAB symptoms. Six sensory dimensions (intensity, unpleasantness, suddenness, perceived difficulty "holding on," bladder fullness and location of sensation) were assessed by structured interview on two occasions. Overactive bladder status was determined using the OAB Symptom Score and OAB Awareness Tool. Reliability of sensory dimensions was assessed via random effects mixed modeling. The ability of each sensory dimension to predict OAB status was determined by partial least squares regression. With the exception of sensory intensity, perceived bladder fullness, and one location of sensation, sensory dimensions were reliably reported. Sensory intensity, unpleasantness, suddenness, and perceived difficulty "holding on" predicted OAB, whereas perceived bladder fullness and sensory location did not. The OAB screening questionnaires demonstrated comparable test-retest reliability and convergent validity. People with and without OAB can reliably describe the multidimensional sensation of desire to void. The sensation of desire to void is more intense, unpleasant, sudden, and perceived as more difficult to hold on in people with OAB.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 06-2011
Publisher: Oxford University Press (OUP)
Date: 15-07-2015
Abstract: The anti-inflammatory activity of long-chain n-3 polyunsaturated fatty acids (PUFAs) has been established in several chronic inflammatory diseases but has yet to be demonstrated in inflammatory lung diseases such as chronic obstructive pulmonary disease (COPD). The aim of this systematic review was to investigate, using PRISMA guidelines, the relationship between the intake of long-chain n-3 PUFAs and the prevalence, severity, and health outcomes of COPD. Eight health databases and the World Health Organization's international clinical trial registry were searched for relevant studies. Experimental or observational studies that were published in English and that assessed long-chain n-3 PUFA intake (by determining habitual consumption and/or tissue levels) in adults with COPD were included. Publication demographics, participant characteristics, type of intervention or exposure, long-chain n-3 PUFA intake, pulmonary function, COPD mortality, and COPD severity were independently extracted from each article by 2 authors using a prospectively designed data extraction tool. All 11 of the studies included in the review were observational. Approximately equal numbers of studies reported significant (n = 6, 5 inverse) relationships or no significant relationships (n = 5) between either consumption of long-chain n-3 PUFAs or levels of long-chain n-3 PUFAS in tissue and a COPD outcome. Current evidence of a relationship between long-chain n-3 PUFA intake and COPD is limited and conflicting, with studies having wide methodological variation. PROSPERO 2013:CRD42013004085.
Publisher: Wiley
Date: 22-10-2015
DOI: 10.1111/RESP.12419
Abstract: Previous systematic reviews have confirmed the benefits of both exercise training and psychological interventions in people with chronic obstructive pulmonary disease (COPD). The objective of this systematic review was to examine the effect of interventions which combine exercise training and psychological interventions for a range of health outcomes in people with COPD. Database searches identified randomized controlled trials of people with COPD participating in interventions that combined exercise training with a psychological strategy compared with control (usual care, waiting list) or active comparators (education, exercise, psychological interventions alone). Health outcomes included dyspnoea, anxiety, depression, quality of life or functional exercise capacity. Standardized mean differences (SMD) were calculated for each intervention arm/control comparison. Across the 12 included studies (738 participants), compared with control conditions, SMD consistently favoured interventions which included both exercise + psychological components (SMD range dyspnoea -1.63 to -0.25 anxiety -0.50 to -0.20 depression -0.46 to -0.18 quality of life 0.09 to 1.16 functional exercise capacity 0.22 to 1.23). When compared with active comparators, SMD consistently favoured interventions that included exercise training + psychological component for dyspnoea (SMD range -0.35 to -0.97), anxiety (SMD range -0.13 to -1.00) and exercise capacity (SMD range 0.64 to 0.71) but were inconsistent for depression (-0.11 to 1.27) and quality of life (0.02 to -2.00). The magnitude of effect for most interventions was greater than the minimum required for clinical significance (i.e. > 0.32) in behavioural medicine. While interventions, outcomes and effect sizes differed substantially between studies, combining exercise training with a psychological intervention may provide a means of optimizing rehabilitation in people with COPD.
Publisher: Daedalus Enterprises
Date: 12-05-2015
Abstract: In patients with COPD, psychological interventions usually target generalized anxiety and depression rather than the sensation of breathlessness. The objectives of this pilot study were to develop and implement a cognitive behavioral therapy (CBT) program specific to the perceptual experience of breathlessness, identify practical issues in the study protocol, and estimate beneficial effects of combining the CBT program with comprehensive pulmonary rehabilitation. The CBT program for the sensation of breathlessness (Breathing: Recognize sensations, Explore thoughts and beliefs, Validate thoughts as useful or harmful, Evolve and change behavior [BREVE]) was developed as a sequential series of 8 modules enabling it to be embedded within an 8-week comprehensive pulmonary rehabilitation program. When appropriate, outcomes from the pilot group (comprehensive pulmonary rehabilitation program + BREVE) were compared with those from a retrospective control group (comprehensive pulmonary rehabilitation program only). Outcomes included feedback provided by pilot study subjects, sensation of breathlessness (volunteered and endorsed descriptors of breathlessness), 6-min walk distance (6MWD), and St George Respiratory Questionnaire (SGRQ) total score. Within-group analyses were undertaken for descriptors of breathlessness (the McNemar test), whereas between-group analyses (repeated-measures analysis of variance, effect-size comparison) were conducted for the 6MWD and SGRQ total score. Pilot (n = 11) and control (n = 58) groups were not significantly different at baseline. Feedback indicated that the program structure and content were positively received. No significant changes were evident for the sensation of breathlessness or the SGRQ score (< 4 points). The 6MWD improved significantly in both groups, with the pilot group demonstrating greater gains compared with the control group (mean change of 57 m and effect size of 0.73 vs mean change of 27 m and effect size of 0.23 between groups, P = .03, effect size of 0.69). The CBT program for the perceptual experience of breathlessness was feasible and well accepted by subjects, although the protocol raised a number of methodological limitations warranting modification. A larger randomized controlled trial is needed to determine the effectiveness and longer-term outcomes.
Publisher: SAGE Publications
Date: 31-07-2023
DOI: 10.1177/17470161231189602
Abstract: Many countries, including Australia, have established a national scheme that supports the recognition of a single ethical review for multi-centre research conducted in publicly funded health services. However, local site-specific governance review processes remain decentralised and highly variable. This short report describes the ethics and governance processes required for a negligible risk national survey of physiotherapy-led airway clearance services in Australia. We detail inconsistencies in research governance document preparation and submission (platforms, processes, forms and signatories) and report the time cost and likely impact of these inconsistencies on health services research outcomes. Processes and strategies that facilitated success in this project are identified and summarised as helpful hints to other researchers looking to embark on negligible risk research in public health facilities.
Publisher: Oxford University Press (OUP)
Date: 02-08-2019
DOI: 10.1093/PTJ/PZZ111
Abstract: Blinding of participants and therapists in trials of physical interventions is a significant and ongoing challenge. There is no widely accepted sham protocol for dry needling. The purpose of this review was to summarize the effectiveness and limitations of blinding strategies and types of shams that have been used in dry needling trials. Twelve databases were searched from inception to February 2016. Trials that compared active dry needling with a sham that simulated dry needling were included. The main domains of data extraction were participant/therapist details, intervention details, blinding strategies, blinding assessment outcomes, and key conclusions of authors. Reported blinding strategies and sham types were synthesized descriptively, with available blinding effectiveness data synthesized using a chance-corrected measurement of blinding (blinding index). The search identified 4894 in idual publications with 27 trials eligible for inclusion. In 22 trials, risk of methodological bias was high or unclear. Across trials, blinding strategies and sham types were heterogeneous. Notably, no trials attempted therapist blinding. Sham protocols have focused on participant blinding using strategies related to group standardization and simulation of tactile sensations. There has been little attention given to the other senses or cognitive strategies to enhance intervention credibility. Nonpenetrating sham types may provide effective participant blinding. Trials were clinically and methodologically erse, which limited the comparability of blinding effectiveness across trials. Reported blinding evaluations had a high risk of chance findings with power clearly achieved in only 1 trial. Evidence-based consensus on a sham protocol for dry needling is required. Recommendations provided in this review may be used to develop sham protocols so that future protocols are more consistent and potentially more effective.
Publisher: Wiley
Date: 21-03-2017
DOI: 10.1002/NAU.22992
Abstract: To develop and assess structure, test-retest reliability, and discriminative validity of a self-report questionnaire (University of South Australia Urinary Sensation Assessment: USA The USA Questionnaires were returned by 189 eligible participants in Study 1 and 211 in Study 2. Exploratory factor analysis revealed three subscales: "urgency," "affective," "fullness." Confirmatory factor analysis supported these subscales. Subscale and total scores were significantly different between groups with and without OAB (P < 0.001). Cohen's d effect sizes (95%CI) were total score 1.8 (0.5-3.1), "urgency" subscale 1.8 (1.3-2.3), "affective" 1.7 (0.95-2.4), and "fullness" 0.75 (0.42-1.09). Total and subscales scores demonstrated test-retest reliability ICCs (95%CIs) of 0.95 (0.9-0.98), 0.96 (0.92-0.98), 0.94 (0.88-0.97), and 0.78 (0.56-0.89). The USA
Publisher: Informa UK Limited
Date: 2005
DOI: 10.1080/09593980500321093
Abstract: Outcome measurements are used to determine the effectiveness of patient management. This study aimed to identify the outcome measures used in the physiotherapy management of lung transplant patients in Australia and New Zealand, and the factors influencing their use. A cross-sectional, descriptive, qualitative design was used to survey physiotherapists working with pre and post lung transplant patients in all major transplant centres and associated hospitals in Australia and New Zealand. The survey instrument was developed in consultation with transplant physiotherapists. The instrument included three main areas demographics, specific outcome measures and therapist perceptions regarding the usefulness of current measurement tools. Physiotherapists participating in this survey were sent a copy of the survey tool and then were interviewed by phone. Eighteen physiotherapists (response rate 86%) from seventeen hospitals completed the survey. On average, participants estimated that their physiotherapy departments had managed 19 (SD 28, range 1-100) pre-transplant patients and 26 (SD 55.9, range 0-200) post-transplant patients in the past year. The most common outcome measures used were exercise tolerance tests, dyspnea scores, and ability to carry out activities of daily living. Time, reliability/validity issues and equipment requirements were reported to be the key factors influencing the use of outcome measures.
Publisher: Elsevier BV
Date: 04-2009
Publisher: Springer Science and Business Media LLC
Date: 25-03-2013
No related grants have been discovered for Marie Williams.