122 research outputs found
I01 Investigating the relationship between minute ventilation and metabolic contribution in long COVID: A retrospective cohort study utilizing cardiopulmonary exercise testing
No full textLong COVID (LC) presents as a complex and debilitating condition characterized by persistent, episodic symptoms that significantly impact individuals' quality of life and functional capabilities (Brown et al., 2021, BMJ Glob Health, 6). There are several hypotheses for the underlying pathophysiology and mechanisms of long COVIDs nature. This study aims to explore the association between minute ventilation and metabolic contribution in individuals experiencing long-term COVID-19 symptoms. Utilising cardiopulmonary exercise testing (CPET), acknowledged as precise, non-invasive prognostic tools, to evaluate cardio-respiratory response to incremental exercise, aiding in the assessment of impaired cardio-respiratory function and perfusion. A cohort observation study was conducted, involving patients with confirmed COVID-19 diagnoses and persistent symptoms three months post-infection, aged between 18 to 65 years. Patients undergo three visits at the university: a baseline assessment, followed by two sessions involving the CPET, spaced 24 hours apart. The baseline visit includes gathering anthropometric data, lung function tests (MIP/MEP), questionnaires, symptom profiling and functional capacity assessments (6MWT and TUG). Data from these assessments determine CPET starting loads based on three stratas: Strata I (6MWD < 350 m, starting load of 10 W), Strata II (6MWD 350-400 m, starting load of 20 W), and Strata III (6MWD > 400 m, starting load of 30 W). Subsequent sub-maximal CPET sessions are conducted to test integrated physiological responses to exercise while preventing PEM/PESE. Measurements include pulmonary gas exchange, ventilation, ventilatory thresholds, and blood profiling. Analysis at present is ongoing. No adverse events or serious adverse events occurred during data collection. Results from this investigation provide insights into the physiological mechanisms underlying long COVID and contribute to the development of tailored management strategies for affected individuals. CPET is the gold standard for assessing cardiorespiratory fitness (CRF) and is vital for understanding LC treatment (Faghy et al., 2024, Prog Card Disease). The use of 2-day CPET methods are increasingly used to identify aerobic deficits and physiological deficits in chronic diseases like ME/CFS and LC. Despite risks, CPET measurements offer insight into pulmonary-vascular function and CRF impairment post-COVID-19 infection (Faghy et al., 2020, Brit J Anaes, 125, 447-449)
A narrative review on increased prevalence of cardiovascular complications following a COVID-19 infection: The risks and considerations for effective management and practice
No full textThe COVID-19 pandemic has been one of the largest risks to global population health in recent years, and acute infection and the persistent symptoms of long COVID will likely continue to affect global health for years to come. Long COVID is very complex and impacts multiple systems and organs, resulting in an extensive and undulating presentation of symptoms. COVID-19 has been shown to cause various cardiovascular (CV) injuries following acute infection, with many patients suffering long-lasting impairment. This review article discusses the prevalence of CV complications following an acute COVID-19 infection and considers effective prevention and disease management strategies to help restore functional status and quality of life in patients
A Systematic Review Approach Using the Behaviour Change Wheel, COM-B Behaviour Model and Theoretical Domains Framework to Evaluate Physical Activity Engagement in a University Setting
No full textIntroduction: Physical activity has been recognised to offer health benefits and reduce the
risks of developing chronic diseases such as diabetes, cardiovascular diseases, hypertension,
cancer, depression, and atherosclerosis. However, even with the known health benefits of
physical activity, over a quarter of adults globally are physically inactive, which is a serious
public health concern and thus calls for concerted efforts to increase physical activity levels in
diverse settings. A university is a unique setting in which to promote health enhancing
behaviours, such as physical activity, because it offers opportunity to be active (e.g., in-built
sports facilities), provides flexible working conditions to enable staff and students a reasonable
level of autonomy in managing their individual time and endowed with highly educated and
well-informed staff base, which has been previously shown to influence individuals’
engagement in physical activity. Therefore, the overall aim of the PhD research project was to
understand the barriers and enablers to physical activity among university staff and students,
design an intervention informed by this understanding and implement intervention to address
these barriers, in order to create behaviours that lead to better engagement in physical activity.
Methods: A mixed-methods experimental design was utilised throughout the research,
incorporating both qualitative (group interviews) and quantitative (surveys) data collection.
The four experimental studies that make up this programme of work were designed using
established behaviour change models, i.e., the Behaviour Change Wheel (BCW), the
Capability, Opportunity, Motivation-Behaviour (COM-B) model and/or the Theoretical
Domains Framework (TDF). The qualitative data were analysed in Nvivo12 using deductive
content analysis, while the qualitative data were analysed using SPSS Statistical software 26.0,
with significance level set at 0.05.
Results: Six prominent domains were identified as enablers and barriers to physical activity
among university staff and students, i.e., knowledge; social influences; social/professional role
and identity; environmental context and resources; beliefs about capabilities; and intentions
(study 1). About 78.0% of the administrative staff and 67.0% of the PhD students were
physically inactive, i.e., achieving less than 600 MET-minutes/week of moderate intensity
physical activity. A multiple regression analysis showed that of the 14 domains of the TDF,
the ‘physical skills’ domain (t 106 = 2.198, p=0.030) was the only significant predictor of
physical inactivity among the administrative staff, while the ‘knowledge’ (t 99 = 2.018, p=
0.046) and ‘intentions’ (t 99 = 4.240, p=0.001) were the only predictors of physical inactivity
amongst the PhD students (study 2). The administrative staff that were assigned to engage in
supervised exercise sessions (experimental group) reported higher physical skills scores and
overall physical activity levels compared to the control (study 3). The PhD students that were
allocated to the education and intentions group, who received educational materials and asked
to form implementation intentions of times, days and places they intend to carry out physical
activity, reported higher overall physical activity levels compared to other treatment groups,
i.e., intentions only, education only and control groups (study 4).
Conclusion: This thesis contributes to the knowledge on adult’s physical activity by detailing
the development, implementation, and assessment of a bespoke brief 4-week behaviour change
intervention that effectively increased university administrative staff and PhD students’ total
physical activity levels, as well as time spent in physical activity weekly. The university was
established as a unique setting to promote health-enhancing behaviour such as promotion of
physical activity. Therefore, theory-based interventions underpinned by the BCW, COM-B
model and TDF may provide an effective strategy to improve university staff and students’
engagement in physical activity, as well as their overall wellbeing
Co-creating a social science research agenda for Long Covid
No full textIntroductionOur objective was to understand how social scientific research could best address the needs and concerns of patients, families, carers, healthcare professionals, academics, private and public sector professionals, and volunteers from Long Covid charities and support groups and people with lived experience of Long Covid. We worked with different stakeholders to develop a list of research priorities that particularly focused on social science as this is where our collective expertise lies, but similar methods could also be used to set research priorities in the natural sciences, medicine or the humanities.MethodsWe used purposive sampling and conducted two online surveys. The first online survey (N = 57) asked participants to identify their top five questions of concern, which resulted in a list of 253 questions. These questions were then consolidated, refined and edited down to 55 questions, categorized by topic. In the second survey (N = 66), we asked participants to select and rank their top 10 questions from this refined list. The final output was a ranked list of nine questions based on those prioritized by at least 50% of the respondents.ResultsNine research questions were developed concerning (i) treatments, therapies, and strategies; (ii) financial support; (iii) repeated reinfections; (iv) training of healthcare professionals; (v) mental health impact; (vi) future of research funding; (vii) airborne transmissions of COVID-19; (viii) developing therapeutics informed by patients’ experiences; and (ix) socioeconomic impacts of Long Covid. Many of the issues raised mirror those discussed in previous work in the UK and internationally, but additional novel themes emerged, underscoring the value of this collaborative approach.ConclusionOur survey revealed the value of including the voices of diverse individuals affected by Long Covid and those working in this area and highlighted priorities for social science in the field of Long Covid research
Shedding Light on Long Covid Conference
No full textOn Wednesday, October 4, 2023, the Shedding Light on Long Covid Conference took place at the Museum of Making in Derby and online. Aligned with the Shedding Light on Long Covid Sci-Art Public Realm Research Project, co-hosted by the Museum of Making and Derby Cathedral, with support from S.H.E.D, The Royal Society of Arts, and the University of Derby, the conference aimed to nurture collaboration among academics, clinical and industry professionals, and the public in exploring research on long Covid through a place-based approach to knowledge generation.
The day featured a range of activities, including presentations, keynotes, workshops, and networking sessions. The programme sought to encourage dialogue on building a community of research and increasing the capacity for change to address long-standing social issues. CivicLAB, an agent dedicated to driving positive societal change and connecting universities, stakeholders, and communities, facilitated the conference.
Dr. Binita Kane, Consultant Respiratory Physician at Manchester University Foundation Trust and an internationally recognized Long Covid expert, delivered a keynote presentation. Additionally, Dr. Mark Faghy and Dr. Rhiannon Jones presented their research on the creative collaboration between Shedding Light on Long Covid, S.H.E.D, and various stakeholders, providing opportunities for artists and scientists to contribute to public understanding through their practice and research.
A stakeholder panel included representatives from Derby County Community Trust, Derby Cathedral, Museum of Making, Long Covid Kids, and Derby City Council. The event also featured an artist researchers panel, with Dr. Gemma Marmalade exploring explicit oralities of written accounts by Long Covid patients in her performance-based presentation titled "Big Mouth (Voice in my head)." Dr. Xristina Penna reflected on the significance of resting within the Shedding Light on Long Covid exhibit as a re-calibration point and a political act in her presentation "Pauses Matter." Professor Michael Pinchbeck discussed his immersive audio project "Breathturn," Dr. Alice Marshall demonstrated the inner workings of creating choreography via others' voices in "Moving Through Speech - in Real Time," and Tomar Beh, CEO of M-Prez Enterprise, shared insights from the first podcast for young people commissioned by S.H.E.D, focusing on Long Covid experiences and thoughts of individuals aged 6-18 years in Derby.
The conference provided a platform for diverse perspectives and collaborative efforts in shedding light on the multifaceted aspects of Long Covid. It reached a wide audience with circ. 100 , taking part in the day online and in person. It was also followed on with a VIP event and showcase of the installation with invited guests and stakeholders in attendance
Recommendations on the use of artificial intelligence in health promotion
No full textThe purpose of this perspective is to provide recommendations on the use of Artificial Intelligence (AI) in health promotion. To arrive at these recommendations, we followed a 6-step process. The first step was to recruit an international authorship team from the Healthy Living for Pandemic Event Protection (HL- PIVOT) network. This enabled us to achieve an international perspective with insights from Canada, Great Britain, Kenya, Italy, and the US. A philosophical inquiry was conducted addressing 5 questions. What should the relationship be between humans and AI in health promotion? How can the public and professionals trust AI? How can we ensure AI is aligned with our values? How can we ensure the ethical use of data by AI? How can we control AI? 4 hypothetical scenarios were also developed to provide perspectives on: i) Artificial 'Versus' Human Intelligence; ii) AI Empowerment in Self-Care; iii) Could AI Improve Patient Provider Relationship; and iii) The Kenyan Cancer Patient at the Height of a Pandemic. Based on the philosophical inquiry and the scenarios 11 recommendations are made by the HL-PIVOT on the use of AI in health promotion. The golden thread running through these recommendations is a human centric approach. The recommendations begin by suggesting that workforce planning should take account of AI. They conclude with the statement that any serious incidents involving an AI in Health Promotion should be reported to the relevant regulatory authority
Training the inspiratory muscles improves running performance when carrying a 25 kg thoracic load in a backpack
No full textLoad carriage (LC) exercise in physically demanding occupations is typically characterised by periods of low-intensity steady-state exercise and short duration, high-intensity exercise while carrying an external mass in a backpack; this form of exercise is also known as LC exercise. This induces inspiratory muscle fatigue and reduces whole-body performance. Accordingly we investigated the effect of inspiratory muscle training (IMT, 50% maximal inspiratory muscle pressure (PImax) twice daily for six week) upon running time-trial performance with thoracic LC. Nineteen healthy males formed a pressure threshold IMT (n = 10) or placebo control group (PLA; n = 9) and performed 60 min LC exercise (6.5 km h(-1)) followed by a 2.4 km running time trial (LCTT) either side of a double-blind six week intervention. Prior to the intervention, PImax was reduced relative to baseline, post-LC and post-LCTT in both groups (pooled data: 13 ± 7% and 16 ± 8%, respectively, p .05). In IMT only, heart rate and perceptual responses were reduced post-LC (p < .05). Time-trial performance was unchanged post-PLA and improved 8 ± 4% after IMT (p < .05). In summary, when wearing a 25 kg backpack, IMT attenuated the cardiovascular and perceptual responses to steady-state exercise and improved high-intensity time-trial performance which we attribute in part to reduced relative work intensity of the inspiratory muscles due to improved inspiratory muscle strength. These findings have real-world implications for occupational contexts
Long Covid Diaries
No full textThis artistic endeavour revolved around the SHED structure and the Museum of Making, drawing inspiration from the poignant narratives of Long Covid diary entries. The performance, part of Shedding Light on Long Covid, was meticulously crafted to encapsulate the profound sense of solitude experienced by patients while also highlighting the invaluable care and support they discovered through the act of connecting and sharing their journeys.
The musical accompaniment for this performance, composed by Matthew Vale, was intricately woven together using the poignant words extracted from the Long Covid diary entries meticulously collected through Mark Faghy’s clinical research. The result was a harmonious blend of music and narrative, enhancing the emotive impact of the overall presentation.
It is noteworthy that this project manifested in two distinct yet equally compelling forms of expression: a captivating dance film and a poignant live site-specific performance. The dance film, a visual testament to the emotional resonance of the project, encapsulates the essence of the patients' experiences. Simultaneously, the live site-specific performance offered a unique and immersive engagement, allowing the audience to tangibly experience the emotions and narratives conveyed by the performers.
Live performances:
Sat 9th Sept 2023 – 10.30am and 1pm
Sun 17th Sept 2023 – 10.30am and 2pm
Film Piece:
Available online for sheltering audience and was playing in the SHED for the whole installation. Available here: https://youtu.be/VIjUijj4gF0?si=Hm8ks0u4oVHm2uc
Causal systems mapping to promote healthy living for pandemic preparedness: a call to action for global public health.
No full textCOVID-19 has severely impacted population health and well-being globally. Acknowledging that COVID-19 will not be the world's last pandemic, improving healthy living factors (i.e., physical activity, healthful nutrition, healthy weight), which are important in mitigating negative outcomes of future infectious disease pandemics, should be prioritized. Although well-documented, promoting healthy living factors remains challenged by a lack of scalability and sustainability due, in part, to a mismatch between intervention focus on individual behavior change as opposed to recognizing complex and multifactorial causes that prevent people from living healthy lifestyles and maintaining them long-term (such as political will, economic benefits, urban planning, etc.). To recognize this complexity in promoting healthy living, we propose the application of systems science methods for the creation of a comprehensive causal systems map of healthy living factors in the context of COVID-19 to inform future pandemic preparedness. Generating such a map would benefit researchers, practitioners, and policy makers in multi-sector collaborative efforts to improve public health preparedness in the context of future pandemics in a scalable, sustainable, and equitable manner. This effort should be facilitated by a trusted and widely respected governing body with global reach
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