9 research outputs found
Methods of connecting primary care patients with community-based physical activity opportunities : a realist scoping review
No full textFunding: NHS Fife Endowment Fund (Grant Number(s): FIF142).Deemed a global public health problem by the World Health Organization, physical inactivity is estimated to be responsible for one in six deaths in the United Kingdom (UK) and to cost the nation's economy £7.4 billion per year. A response to the problem receiving increasing attention is connecting primary care patients with community-based physical activity opportunities. We aimed to explore what is known about the effectiveness of different methods of connecting primary care patients with community-based physical activity opportunities in the United Kingdom by answering three research questions: 1) What methods of connection from primary care to community-based physical activity opportunities have been evaluated?; 2) What processes of physical activity promotion incorporating such methods of connection are (or are not) effective or acceptable, for whom, to what extent and under what circumstances; 3) How and why are (or are not) those processes effective or acceptable? We conducted a realist scoping review in which we searched Cochrane, Medline, PsycNET, Google Advanced Search, National Health Service (NHS) Evidence and NHS Health Scotland from inception until August 2020. We identified that five methods of connection from primary care to community-based physical activity opportunities had been evaluated. These were embedded in 15 processes of physical activity promotion, involving patient identification and behaviour change strategy delivery, as well as connection. In the contexts in which they were implemented, four of those processes had strong positive findings, three had moderately positive findings and eight had negative findings. The underlying theories of change were highly supported for three processes, supported to an extent for four and refuted for eight processes. Comparisons of the processes and their theories of change revealed several indications helpful for future development of effective processes. Our review also highlighted the limited evidence base in the area and the resulting need for well-designed theory-based evaluations.Peer reviewe
Progressing social prescribing:a recommendation for schemes involving link workers
No full textNew research by Kathryn B Cunningham and colleagues presents three key elements concerning the process of connection in indirect route social prescribing schemes (those involving link workers)
Connecting primary care patients to community-based physical activity : a qualitative study of health professional and patient views
No full textFunding: NHS Fife Endowment Fund Grant which was awarded as part of a larger project (FIF142).Background Inconclusive evidence supporting referrals from health professionals to gym-based exercise programmes has raised concern for the roll-out of such schemes, and highlights the importance of developing links between healthcare settings and community-based opportunities to improve physical activity (PA) levels. Aim This study aimed to identify methods, and explore barriers and facilitators, of connecting primary care patients with PA opportunities from the perspectives of both health professionals (HPs) and patients, using the example of jogs cotland. Design & setting An exploratory study utilising semi-structured interviews with primary care patients (n = 14) and HPs (n = 14) from one UK NHS board was conducted. Method Patient and HP transcripts were analysed separately using thematic analysis. Potential methods of connection were identified. The Capability, Opportunity, Motivation, behavioural (COM-B) model and theoretical domains framework (TDF) were employed to facilitate identification of barriers and facilitators for connecting primary care to community jogscotland groups. Results Three methods of connecting patients to community-based groups were identified: informal passive signposting, informal active signposting, and formal referral or prescribing. Barriers and facilitators for patient connection fell into five TDF domains for HPs and two COM-B model components for patients. Conclusion For patients, HPs raising the topic of PA can help to justify, facilitate, and motivate action to change. The workload associated with connecting patients with community-based opportunities is central to implementation by HPs. Integrative resource solutions and social support for patients can provide a greater variety of PA options and the vital information and support for connecting with local opportunities, such as jogscotland.Peer reviewe
Social prescribing and behaviour change : proposal of a new behaviour change technique concerning the ‘connection’ step
No full textPeer reviewe
Physical activity promotion in primary care:Health professional and patient views on connecting primary care patients with community-based physical activity opportunities
No full textBackground: Inconclusive evidence in support of referrals from health professionals to gym-based exercise programmes has raised a concern for the roll-out of such schemes and highlights the importance of developing and maintaining links between primary care settings and community-based opportunities to improve physical activity levels. This study aimed to identify methods of connecting primary care patients to community-based physical activity opportunities, using the example of jog scotland, and to explore what factors can facilitate this connection.Methods: We conducted a qualitative exploratory study utilising semi-structured interviews with primary care patients (n=14) and health professionals (HP) (n=14) from one UK National Health Service (NHS) board. We analysed the transcripts separately for patients and HPs using thematic analysis and synthesised them for potential methods of connection. Sub-themes for patients and HPs were mapped onto relevant components of the capability, opportunity, motivation behavioural (COM-B) model and theoretical domains framework (TDF) to identify barriers and facilitators for connecting primary care to community jog scotland groups.Results: Three potential methods of connecting patients to community-based jog scotland groups were identified: informal passive signposting, informal active signposting, and formal referral or prescribing. Barriers and facilitators to connecting patients to jog scotland groups fell into five TDF domains for HPs and two COM-B model components for patients.Conclusions: Our findings suggest that for patients, the acknowledgement and raising of the topic of physical activity improvement by their HP can help to justify as well as facilitate and motivate action to change. The workload associated with connecting patients to community-based opportunities is central to the implementation by HPs. Resource solutions (e.g. intermediary person or community information hub) and social support opportunities for patients (e.g. meet and greet) can provide patients with a greater variety of physical activity options and the vital information and support for connecting with local community-based opportunities, such as jog scotland
Progressing social prescribing with a focus on process of connection:Evidence-informed guidance for robust evaluation and evidence synthesis
No full textPeer reviewe
An evaluation of the Agrobacterium tumefaciens Virulence gene system as a potential diagnostic test for Neuroblastoma.
No full textNeuroblastoma is a common pediatric cancer, the prognosis for which is markedly dependent upon the progression of the disease at the time of diagnosis. It has been argued that a mass screening programme for all infants would aid early detection of neuroblastoma and reduce mortality. Neuroblastoma is unusual amongst childhood cancers since the basis for such a test exsists - otherwise asymptomatic patients excrete abnormal amounts of specific phenolic compounds in their urine. The presence of these metabolites at elevated levels is taken as diagnostic of the disease. A number of pilot screening programmes in different parts of the world have shown that a quick, inexpensive and reliable method of screening is needed. One candidate for this is a test based upon the responses of Agrobacterium tumefaciens to compounds with structures similar to those produced as a result of tumour metabolism. This bacterium responds to such phenolic ligands chemotactically and by induction of virulence gene expression. Data presented in this work shows that phenolics secreted by neuroblastoma tumours are incapable of inducing virulence gene expression but are capable of acting as chemoattractants. The role of phosphorylation in VirA/G mediated phenolic chemotaxis is investigated. Evidence is presented that phosphorylation of Vir and G is required for chemotaxis. A novel, highly reproducible and comparible measure bacterial chemotaxis, the chemotactic index is derived and applied
CONCEPTT: Continuous Glucose Monitoring in Women with Type 1 Diabetes in Pregnancy Trial: A multi-center, multi-national, randomized controlled trial - Study protocol
No full text© 2016 The Author(s). Background: Women with type 1 diabetes strive for optimal glycemic control before and during pregnancy to avoid adverse obstetric and perinatal outcomes. For most women, optimal glycemic control is challenging to achieve and maintain. The aim of this study is to determine whether the use of real-time continuous glucose monitoring (RT-CGM) will improve glycemic control in women with type 1 diabetes who are pregnant or planning pregnancy. Methods/design: A multi-center, open label, randomized, controlled trial of women with type 1 diabetes who are either planning pregnancy with an HbA1c of 7.0 % to ≤10.0 % (53 to ≤ 86 mmol/mol) or are in early pregnancy (<13 weeks 6 days) with an HbA1c of 6.5 % to ≤10.0 % (48 to ≤ 86 mmol/mol). Participants will be randomized to either RT-CGM alongside conventional intermittent home glucose monitoring (HGM), or HGM alone. Eligible women will wear a CGM which does not display the glucose result for 6 days during the run-in phase. To be eligible for randomization, a minimum of 4 HGM measurements per day and a minimum of 96 hours total with 24 hours overnight (11 pm-7 am) of CGM glucose values are required. Those meeting these criteria are randomized to RT- CGM or HGM. A total of 324 women will be recruited (110 planning pregnancy, 214 pregnant). This takes into account 15 and 20 % attrition rates for the planning pregnancy and pregnant cohorts and will detect a clinically relevant 0.5 % difference between groups at 90 % power with 5 % significance. Randomization will stratify for type of insulin treatment (pump or multiple daily injections) and baseline HbA1c. Analyses will be performed according to intention to treat. The primary outcome is the change in glycemic control as measured by HbA1c from baseline to 24 weeks or conception in women planning pregnancy, and from baseline to 34 weeks gestation during pregnancy. Secondary outcomes include maternal hypoglycemia, CGM time in, above and below target (3.5-7.8 mmol/l), glucose variability measures, maternal and neonatal outcomes. Discussion: This will be the first international multicenter randomized controlled trial to evaluate the impact of RT- CGM before and during pregnancy in women with type 1 diabetes. Trial registration: ClinicalTrials.gov Identifier: NCT01788527Registration Date: December 19, 2012
CONCEPTT: Continuous Glucose Monitoring in Women with Type 1 Diabetes in Pregnancy Trial: A multi-center, multi-national, randomized controlled trial - Study protocol
No full text\ua9 2016 The Author(s). Background: Women with type 1 diabetes strive for optimal glycemic control before and during pregnancy to avoid adverse obstetric and perinatal outcomes. For most women, optimal glycemic control is challenging to achieve and maintain. The aim of this study is to determine whether the use of real-time continuous glucose monitoring (RT-CGM) will improve glycemic control in women with type 1 diabetes who are pregnant or planning pregnancy. Methods/design: A multi-center, open label, randomized, controlled trial of women with type 1 diabetes who are either planning pregnancy with an HbA1c of 7.0 % to ≤10.0 % (53 to ≤ 86 mmol/mol) or are in early pregnancy (<13 weeks 6 days) with an HbA1c of 6.5 % to ≤10.0 % (48 to ≤ 86 mmol/mol). Participants will be randomized to either RT-CGM alongside conventional intermittent home glucose monitoring (HGM), or HGM alone. Eligible women will wear a CGM which does not display the glucose result for 6 days during the run-in phase. To be eligible for randomization, a minimum of 4 HGM measurements per day and a minimum of 96 hours total with 24 hours overnight (11 pm-7 am) of CGM glucose values are required. Those meeting these criteria are randomized to RT- CGM or HGM. A total of 324 women will be recruited (110 planning pregnancy, 214 pregnant). This takes into account 15 and 20 % attrition rates for the planning pregnancy and pregnant cohorts and will detect a clinically relevant 0.5 % difference between groups at 90 % power with 5 % significance. Randomization will stratify for type of insulin treatment (pump or multiple daily injections) and baseline HbA1c. Analyses will be performed according to intention to treat. The primary outcome is the change in glycemic control as measured by HbA1c from baseline to 24 weeks or conception in women planning pregnancy, and from baseline to 34 weeks gestation during pregnancy. Secondary outcomes include maternal hypoglycemia, CGM time in, above and below target (3.5-7.8 mmol/l), glucose variability measures, maternal and neonatal outcomes. Discussion: This will be the first international multicenter randomized controlled trial to evaluate the impact of RT- CGM before and during pregnancy in women with type 1 diabetes. Trial registration: ClinicalTrials.gov Identifier: NCT01788527Registration Date: December 19, 2012
