13361 research outputs found
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An occupational therapy-led trial to improve patient adherence to compression stockings
No full textIntroduction/Rationale: Compression stockings are often prescribed to prevent venous leg ulcer recurrence, but low patient adherence leads to negative health and economic outcomes. To improve adherence, a clinical decision-aid, delivered by occupational therapists, was developed, including the following: an assessment questionnaire to identify the patients' top three barriers to adherence, an algorithm that guides decision making, linking patient-specific barriers with tailored recommendations and resources to guide the development of a tailored treatment plan.Objectives: This study aimed to assess methods and feasibility, including the clinical- and cost-effectiveness of a definitive trial.Method/approach: A two-arm, single-blinded pilot randomised controlled trial with a health economic evaluation was conducted within two tertiary hospital occupational therapy outpatient clinics. Nineteen participants, demonstrating poor baseline adherence, were randomised to receive either usual-care or the intervention, where the clinician utilised the aid. Each participant received 6 months of care. Stocking-adherence and other clinical outcomes including quality-of-life were measured. Analyses included descriptive and inferential statistics.Results/practice implications: The methodology was feasible. The intervention group using the aid showed significantly better adherence than the usual-care group (p = 0.002), with improved adherence strongly correlated with resolving individual patient barriers (p < 0.001). Health utility analysis indicated that while the intervention was slightly more expensive, it was more effective than usual care.Conclusion: The study demonstrated the feasibility of the research methodology for a definitive trial. Despite the small sample size, the pilot indicated that the clinical decision-aid has potential for improving stocking adherence in a cost-effective way among individuals at risk of venous leg ulcer recurrence
Leveraging digital technology to improve environmental, social, and governance performance of infrastructure projects
Get PDFPurpose:This research explores how digital technologies can improve the environmental (E), social (S) and governance (G) performance of infrastructure projects.Design/methodology/approach:Grounded in the dynamic capability view (DCV), this study adopted an exploratory qualitative approach. Semi-structured interviews were conducted with infrastructure professionals experienced in digital transformation and Environmental, Social, and Governance (ESG). An inductive thematic analysis was applied to derive insights directly from the data. To interpret and refine the emerging themes in relation to DCV, the research employed an abductive logic through a process of systematic combining allowing theory and empirical data to iteratively inform each other.Findings:The results revealed that digital transformation improves ESG performance through informed decision making using real-time data, reduces time consumption in manual data processing, enhances system complexities and facilitates local and global standardization of ESG performance. Furthermore, digital technologies have far-reaching impacts on data collection, structuring, reporting and transparency. Environmental (E), social (S) and governance (G) elements of ESG can significantly be promoted using advanced technologies. The drivers and challenges associated with the adoption of digital technologies to improve ESG performance of infrastructure projects are also highlighted.Practical implications:The findings of this research offer valuable insights to infrastructure professionals aiming to improve ESG performance to achieve net-zero targets, promote sustainable investment and enhance competitive advantages by adopting digital transformation in the era of digital economy.Originality/value:There is dearth of empirical studies focusing on qualitative research methods that explore the use of digital technologies to advance the performance of infrastructure projects within the framework of ESG
Relationship Between Training Load and Injuries in Law Enforcement Recruits
Get PDFBackground:Law enforcement agencies typically conduct academy training to develop new officers. As these future officers are recruited from the general population, increases in physical workload during academy training can influence injury risk. This study explored the relationshipbetween training load (TL) and injury risk among police officer recruits.Methods:Data relating to injuries suffered, distance covered, physical fitness, and time spent in physical training were collected from 547 academy police recruits (431 male; 116 female). Course length varied between 20 and 22 weeks. A generalised linear mixed model was used to assess relationships between these variables and injury risk. The best fitting model was chosen using a stepwide approach with Akaikeinformation criterion (AIC) and Bayesian information criterion (BIC)used for comparison.Results:The best fitting model utilised weekly distance, week of training, and biological sex to predict injury (χ2= 38.3, p-value < 0.001). Higher weekly distances, earlier weeks of academy training, and female sex all resulted in higher probabilities of injury.Conclusions:Rapid increases in TL (distance) during the transition from civilian to law enforcement recruit and lower fitness levels (resilience to TL) may lead to higher injury risk. The use of occupationally specific periodised, ability-based, training may lead to a more optimal TL forrecruits, limiting overtraining while sufficiently developing fitness
Effectiveness of Exercise-Based Interventions on Molecular Biomarkers in Head and Neck Cancer (HNC) Survivors: A Systematic Review
Get PDFPurpose:HNC poses significant health challenges globally with over 650 000 new cases annually. Studies have demonstrated the benefits of exercise for many cancer types, with several exploring the effects of exercise on various molecular biomarkers. However, no study has systematically explored these effects among HNC survivors.Methods:Studies published up to February 2024 were screened on PubMed, SCOPUS and Web of Science using relevant keywords yielding 838 results. Studies that explored the effect of exercise-based interventions on molecular biomarkers among HNC survivors were eligible for inclusion. Risk of bias was assessed using the Joanna Briggs Institute quality assessment tool.Results:Three studies were included in the review. Primary biomarkers assessed were inflammatory (eg, IL-6, TNF-α), oxidative stress (eg, 8-OHdG, MDA), and collagen fragment markers (eg, IC6, ProC3). Significant changes were observed in collagen fragment markers, specifically Pro C3, IC6 and IC6/C6M over time, although no correlation with lean body mass was found. Oxidative stress markers improved following exercise, with increases in total antioxidant capacity, decreases in 8-OHdG and carbonyl content. However, no significant changes were found in inflammatory markers or DNA methylation patterns post-intervention.Conclusion:Our review suggests that exercise shows potential in modulating physiological and molecular pathways’ among HNC survivors. Although only 3 studies were eligible for inclusion, these benefits might potentially translate into improvements in health-related outcomes amongst HNC survivors. Future large-scale trials with standardized exercise protocols and extended follow-up periods might improve our understanding of the long-term effects of exercise on biomarkers and survivorship outcomes in HNC
The association between ‘Vegetarian for Life’ diet quality, social connection and depressive symptoms within Western and Indian regional groups
No full textBackground:Dietary patterns rich in plant foods have been broadly associated with a lower risk of depression due to the profile of bioactive components related to positive physical and neurological mechanisms of effect. Yet vegans and vegetarians are reported to experience higher depressive symptoms, a profile of psychological and physiological symptoms that indicate poor mental health. The role of eating behaviors within sociocultural contexts associated with dietary intake is one aspect of psychological functioning that has received limited attention.Methods:We explored diet quality, social connectedness and depressive symptoms in 312 lifelong adult vegans (51 %) and vegetarians (49 %) from Western and Indian populations.Results:Hierarchical linear regression revealed that higher diet quality was associated with lower depressive symptoms (β = −0.11, t = −2.86, p < .05). Those in the lowest diet quality quartile experienced significantly higher depressive symptoms (M = 18.7, SD = 9.56), than those in the medium (M = 12.3, SD = 12.13) and highest (M = 10.38, SD = 9.60) diet quality quartiles. But, when social connectedness was included in a within-populations analysis, diet quality was no longer a significant predictor for the Indian population.Conclusions:The results underscore the importance of considering socio-cultural dimensions to adherence to dietary patterns, the context of dietary quality and social connection when examining depressive symptoms
Performance progression of youth and Junior triathletes racing world triathlon sprint and super sprint races
No full textEurope stages highly competitive World Triathlon Youth and Junior competitions. Results from 46 sprint and super sprint European triathlon events between 2021 and 2023 included 2137 competition data entries of 494 males and 1576 entries of 351 females. The competition split-times were converted to average velocity to account for competition distance variability. Performance trajectories were estimated using linear mixed model regression and subdivided by sex, competition distance, and segment with age as the main factor of interest. Random effects included competition's external factors, intra-athlete variability, and country of origin. Estimated velocity was not statistically different between sprint and super sprint distances in female swim, and male and female cycle, run, and full-race. Males were faster than females in all segments and across all ages. The total estimated performance progression from 15 to 19 years-of-age was small for adolescent triathletes: males (swimming ~4.2%; cycling ~3.2%; running ~6.0%); females (swimming ~2.4%; cycling ~1.7%; running ~4.1%). Age explained <7.0% of performance progression. Performance variance explained by random effects differed by sex, distance and segment. Despite the small contribution of age, the most successful adolescent triathletes continually develop at rates determined by sex. </p
Patient-level financial incentives in cardiovascular risk management and secondary prevention. A systematic review with meta-analysis
No full textAim:To evaluate the effectiveness of financial incentives for individuals with or at risk of cardiovascular disease (CVD), in promoting adherence with primary and secondary prevention.Methods:Systematic review and meta-analysis following PRISMA guidelines. PubMed, CINAHL and ProQuest Central databases were searched for randomised controlled trials (RCTs) involving adults with one or more CVD risk factors. Included interventions were financial incentives for lifestyle, exercise and/or guideline-recommended pharmacotherapy, compared to controls without financial rewards. Adherence with the recommended intervention, clinical and economic outcomes were extracted. Data unsuitable for meta-analysis was reported descriptively. Critical appraisal was undertaken using Joanna Briggs Institute tools.Results:The search identified 1,462 studies, after screening 34 RCTs were included with total recruitment of 35,102 patients. Financial incentive types spanned medication co-payment abolishment, lotteries, process or outcome-based, loss or gain-framed mechanisms ranging from approximately AU$5–178 per week (inflation adjusted). In pooled analysis of varied outcomes, financial incentives modestly improved clinical parameters (Standard Mean Difference (SMD) 0.11 (0.03–0.190), I2 63%, p=0.009, 18 trials, n=14,792) and consistently improved adherence with medication and lifestyle interventions (Odds Ratio 2.06 (1.55–2.75), I2 81%, p=0.00001, 8 trials, n=15,613, Figure). High heterogeneity was observed due to diversity of incentives and outcomes. Subgroup analyses indicated that some clinical outcomes (such as weight) regularly improved with incentives, yet haematological parameters and hospital admissions were frequently unchanged.Conclusions:This systematic review found financial incentives improve adherence with primary and secondary prevention strategies and may improve some clinical parameters
Blue, green, brown, or something in between – the science of eye colour explained
No full textYou’re introduced to someone and your attention catches on their eyes. They might be a rich, earthy brown, a pale blue, or the rare green that shifts with every flicker of light. Eyes have a way of holding us, of sparking recognition or curiosity before a single word is spoken. They are often the first thing we notice about someone, and sometimes the feature we remember most.Across the world, human eyes span a wide palette. Brown is by far the most common shade, especially in Africa and Asia, while blue is most often seen in northern and eastern Europe. Green is the rarest of all, found in only about 2% of the global population. Hazel eyes add even more diversity, often appearing to shift between green and brown depending on the light.So, what lies behind these differences
Costo-Osteochondral Autograft for the Non-salvageable Proximal Scaphoid: A Systematic Review
No full textBackground: Scaphoid non-union is a challenging condition that can lead to chronic wrist pain, decreased range of motion (ROM) and functional impairment. One promising approach involves the use of costo-osteochondral rib autografts, offering a non-vascularised and structurally supportive environment for bone regeneration. This systematic review aims to evaluate the current evidence regarding the management of non-salvageable scaphoid proximal poles and non-union using rib costo-osteochondral autografts.Methods: A comprehensive search of electronic databases was conducted. Data extraction was performed independently by two authors. The primary outcomes were ROM, grip strength, pain, functional outcomes and complications.Results: A total of six studies were identified that met the inclusion criteria. A total of 101 patients had undergone scaphoid costo-osteochondral autografting with a rib donor. Postoperative active ROM arc had a mean of 112° (range: 78°–125°), with grip strength mean of 34 kg (range: 22–50 kg). Various functional outcome measures were reported, such as the QuickDASH, Patient Rated Wrist Evaluation (PRWE) and Visual Analogue Scale (VAS), with overall improvement noted for function and pain. Complications were reported in 10% of cases, including four donor site complications.Conclusions: The available literature supports the use of costo-osteochondral rib autografts to treat the non-salvageable proximal scaphoid, with short-term improvement in ROM and function. However, given the heterogeneity of the included studies and the limited number of high-quality randomised controlled trials, further research is needed to establish the optimal graft selection for scaphoid AVN or non-union
RE: Invasive cervical cancer incidence following bivalent human papillomavirus vaccination: A population-based observational study of age at immunization, dose, and deprivation
No full textIn this article, Palmer and colleagues1 made certain claims regarding the impact of HPV vaccination in Scotland that on reanalysis of their data we find to contain inaccuracies. These inaccurate claims were reported widely in the media