14 research outputs found
Exploring the role of mindfulness as a potential self-management strategy for physiotherapy students when on placement
Get PDFHealthcare programmes tend to neglect exploring self-care strategies for students whilst they are
on their clinical placements. There is evidence that students experience placements as
challenging because of the long hours, and endeavouring to meet the needs of many patients
across diverse challenging settings. Mindfulness is a potential self-management strategy to
enable students to manage the challenges and resultant stress during these times, and to work
optimally within their competences. This study explores the role of mindfulness in attempting to
meet these challenges. Purposive sampling was used to recruit nineteen MSc pre-registration
physiotherapy students who received a two-hour mindfulness intervention prior to commencing
their placement, and were encouraged to practice mindfulness for 30 minutes three times a week
with a CD whilst on placement or in their own time. Additionally, they were asked to practice for
10-15 minutes ‘mindfulness of the breath’ during this period. A qualitative approach that
incorporated thematic analysis was used to analyse the audio-recorded and transcribed pre- and
post-placement focus groups. Perceived benefits from practising mindfulness were: a lessening
of intrinsic stress, and an ability to cope with extrinsic stress with increased clarity and objectivity.
The CD proved burdensome amongst the students, largely owing to time constraints, but this did
not deter their desire to implement mindfulness during this time, and they devised alternative and
individual modes of practicing this mind-body-based approach. This study lends evidence to
support inclusion of mindfulness into the physiotherapy curriculum as a self
Trial of N-Acetyl-l-Leucine in Niemann–Pick Disease Type C
Get PDFBACKGROUND: Niemann–Pick disease type C is a rare lysosomal storage disorder. We evaluated the safety and efficacy of N-acetyl-l-leucine (NALL), an agent that potentially ameliorates lysosomal and metabolic dysfunction, for the treatment of Niemann–Pick disease type C. /
METHODS: In this double-blind, placebo-controlled, crossover trial, we randomly assigned patients 4 years of age or older with genetically confirmed Niemann–Pick disease type C in a 1:1 ratio to receive NALL for 12 weeks, followed by placebo for 12 weeks, or to receive placebo for 12 weeks, followed by NALL for 12 weeks. NALL or matching placebo was administered orally two to three times per day, with patients 4 to 12 years of age receiving weight-based doses (2 to 4 g per day) and those 13 years of age or older receiving a dose of 4 g per day. The primary end point was the total score on the Scale for the Assessment and Rating of Ataxia (SARA; range, 0 to 40, with lower scores indicating better neurologic status). Secondary end points included scores on the Clinical Global Impression of Improvement, the Spinocerebellar Ataxia Functional Index, and the Modified Disability Rating Scale. Crossover data from the two 12-week periods in each group were included in the comparisons of NALL with placebo. /
RESULTS: A total of 60 patients 5 to 67 years of age were enrolled. The mean baseline SARA total scores used in the primary analysis were 15.88 before receipt of the first dose of NALL (60 patients) and 15.68 before receipt of the first dose of placebo (59 patients; 1 patient never received placebo). The mean (±SD) change from baseline in the SARA total score was −1.97±2.43 points after 12 weeks of receiving NALL and −0.60±2.39 points after 12 weeks of receiving placebo (least-squares mean difference, −1.28 points; 95% confidence interval, −1.91 to −0.65; P<0.001). The results for the secondary end points were generally supportive of the findings in the primary analysis, but these were not adjusted for multiple comparisons. The incidence of adverse events was similar with NALL and placebo, and no treatment-related serious adverse events occurred. /
CONCLUSIONS: Among patients with Niemann–Pick disease type C, treatment with NALL for 12 weeks led to better neurologic status than placebo. A longer period is needed to determine the long-term effects of this agent in patients with Niemann–Pick disease type C. (Funded by IntraBio; ClinicalTrials.gov number, NCT05163288. opens in new tab; EudraCT number, 2021-005356-10. opens in new tab.
Rehabilitation using virtual gaming for Hospital and hOMe-Based training for the Upper limb post Stroke (RHOMBUS II): protocol of a feasibility randomised controlled trial
Get PDFIntroduction Upper limb (UL) rehabilitation is most effective early after stroke, with higher doses leading to improved outcomes. For the stroke survivor, the repetition may be monotonous. For clinicians, providing a clinically meaningful level of input can be challenging. As such, time spent engaged in UL activity among subacute stroke survivors remains inadequate. Opportunities for the stroke survivor to engage with UL rehabilitation in a safe, accessible and engaging way are essential to improving UL outcomes following stroke. The NeuroBall is a non-immersive virtual reality (VR) digital system designed for stroke rehabilitation, specifically for the arm and hand. The aim of the Rehabilitation using virtual gaming for Hospital and hOMe-Based training for the Upper limb post Stroke study is to determine the safety, feasibility and acceptability of the NeuroBall as a rehabilitation intervention for the UL in subacute stroke.
Methods and analysis A feasibility randomised controlled trial (RCT) will compare the NeuroBall plus usual care with usual care only, in supporting UL rehabilitation over 7 weeks. Twenty-four participants in the subacute poststroke phase will be recruited while on the inpatient or early supported discharge (ESD) stroke pathway. Sixteen participants will be randomised to the intervention group and eight to the control group. Outcomes assessed at baseline and 7 weeks include gross level of disability, arm function, spasticity, pain, fatigue and quality of life (QoL). Safety will be assessed by recording adverse events and using pain, spasticity and fatigue scores. A parallel process evaluation will assess feasibility and acceptability of the intervention. Feasibility will also be determined by assessing fidelity to the intervention. Postintervention, semistructured interviews will be used to explore acceptability with 12 participants from the intervention group, four from the usual care group and with up to nine staff involved in delivering the intervention.
Ethics and dissemination This trial has ethical approval from Brunel University London’s Research Ethics Committee 25257-NHS-Oct/2020-28121-2 and the Wales Research Ethics Committee 5 Bangor (Health and Care Research Wales) REC ref: 20/WA/0347. The study is sponsored by Brunel University London. Contact: Dr Derek Healy, Chair, University Research Ethics committee ([email protected]). Trial results will be submitted for publication in peer-reviewed journals, presented at national and international conferences and distributed to people with stroke.
Trial registration number ISRCTN11440079; Pre-results
ReSurveyEurope : A database of resurveyed vegetation plots in Europe
Get PDFAims: We introduce ReSurveyEurope — a new data source of resurveyed vegetation
plots in Europe, compiled by a collaborative network of vegetation scientists. We de-
scribe the scope of this initiative, provide an overview of currently available data,
governance, data contribution rules, and accessibility. In addition, we outline further
steps, including potential research questions.
Results: ReSurveyEurope includes resurveyed vegetation plots from all habitats.
Version 1.0 of ReSurveyEurope contains 283,135 observations (i.e., individual sur-
veys of each plot) from 79,190 plots sampled in 449 independent resurvey projects.
Of these, 62,139 (78%) are permanent plots, that is, marked in situ, or located with
GPS, which allow for high spatial accuracy in resurvey. The remaining 17,051 (22%)
plots are from studies in which plots from the initial survey could not be exactly
relocated. Four data sets, which together account for 28,470 (36%) plots, provide
only presence/absence information on plant species, while the remaining 50,720
(64%) plots contain abundance information (e.g., percentage cover or cover–abun-
dance classes such as variants of the Braun- Blanquet scale). The oldest plots were
sampled in 1911 in the Swiss Alps, while most plots were sampled between 1950
and 2020.
Conclusions: ReSurveyEurope is a new resource to address a wide range of re-
search questions on fine-scale changes in European vegetation. The initiative is de-
voted to an inclusive and transparent governance and data usage approach, based
on slightly adapted rules of the well-established European Vegetation Archive (EVA).
ReSurveyEurope data are ready for use, and proposals for analyses of the data set
can be submitted at any time to the coordinators. Still, further data contributions are
highly welcom
ReSurveyEurope: A database of resurveyed vegetation plots in Europe
Get PDFAbstract Aims We introduce ReSurveyEurope — a new data source of resurveyed vegetation plots in Europe, compiled by a collaborative network of vegetation scientists. We describe the scope of this initiative, provide an overview of currently available data, governance, data contribution rules, and accessibility. In addition, we outline further steps, including potential research questions. Results ReSurveyEurope includes resurveyed vegetation plots from all habitats. Version 1.0 of ReSurveyEurope contains 283,135 observations (i.e., individual surveys of each plot) from 79,190 plots sampled in 449 independent resurvey projects. Of these, 62,139 (78%) are permanent plots, that is, marked in situ, or located with GPS, which allow for high spatial accuracy in resurvey. The remaining 17,051 (22%) plots are from studies in which plots from the initial survey could not be exactly relocated. Four data sets, which together account for 28,470 (36%) plots, provide only presence/absence information on plant species, while the remaining 50,720 (64%) plots contain abundance information (e.g., percentage cover or cover–abundance classes such as variants of the Braun‐Blanquet scale). The oldest plots were sampled in 1911 in the Swiss Alps, while most plots were sampled between 1950 and 2020. Conclusions ReSurveyEurope is a new resource to address a wide range of research questions on fine‐scale changes in European vegetation. The initiative is devoted to an inclusive and transparent governance and data usage approach, based on slightly adapted rules of the well‐established European Vegetation Archive (EVA). ReSurveyEurope data are ready for use, and proposals for analyses of the data set can be submitted at any time to the coordinators. Still, further data contributions are highly welcome
<scp>ReSurveyEurope</scp>: A database of resurveyed vegetation plots in Europe
Get PDFAbstractAimsWe introduce ReSurveyEurope — a new data source of resurveyed vegetation plots in Europe, compiled by a collaborative network of vegetation scientists. We describe the scope of this initiative, provide an overview of currently available data, governance, data contribution rules, and accessibility. In addition, we outline further steps, including potential research questions.ResultsReSurveyEurope includes resurveyed vegetation plots from all habitats. Version 1.0 of ReSurveyEurope contains 283,135 observations (i.e., individual surveys of each plot) from 79,190 plots sampled in 449 independent resurvey projects. Of these, 62,139 (78%) are permanent plots, that is, marked in situ, or located with GPS, which allow for high spatial accuracy in resurvey. The remaining 17,051 (22%) plots are from studies in which plots from the initial survey could not be exactly relocated. Four data sets, which together account for 28,470 (36%) plots, provide only presence/absence information on plant species, while the remaining 50,720 (64%) plots contain abundance information (e.g., percentage cover or cover–abundance classes such as variants of the Braun‐Blanquet scale). The oldest plots were sampled in 1911 in the Swiss Alps, while most plots were sampled between 1950 and 2020.ConclusionsReSurveyEurope is a new resource to address a wide range of research questions on fine‐scale changes in European vegetation. The initiative is devoted to an inclusive and transparent governance and data usage approach, based on slightly adapted rules of the well‐established European Vegetation Archive (EVA). ReSurveyEurope data are ready for use, and proposals for analyses of the data set can be submitted at any time to the coordinators. Still, further data contributions are highly welcome.</jats:sec
Effect of remote ischaemic conditioning on clinical outcomes in patients with acute myocardial infarction (CONDI-2/ERIC-PPCI): a single-blind randomised controlled trial.
Get PDFBACKGROUND: Remote ischaemic conditioning with transient ischaemia and reperfusion applied to the arm has been shown to reduce myocardial infarct size in patients with ST-elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PPCI). We investigated whether remote ischaemic conditioning could reduce the incidence of cardiac death and hospitalisation for heart failure at 12 months. METHODS: We did an international investigator-initiated, prospective, single-blind, randomised controlled trial (CONDI-2/ERIC-PPCI) at 33 centres across the UK, Denmark, Spain, and Serbia. Patients (age >18 years) with suspected STEMI and who were eligible for PPCI were randomly allocated (1:1, stratified by centre with a permuted block method) to receive standard treatment (including a sham simulated remote ischaemic conditioning intervention at UK sites only) or remote ischaemic conditioning treatment (intermittent ischaemia and reperfusion applied to the arm through four cycles of 5-min inflation and 5-min deflation of an automated cuff device) before PPCI. Investigators responsible for data collection and outcome assessment were masked to treatment allocation. The primary combined endpoint was cardiac death or hospitalisation for heart failure at 12 months in the intention-to-treat population. This trial is registered with ClinicalTrials.gov (NCT02342522) and is completed. FINDINGS: Between Nov 6, 2013, and March 31, 2018, 5401 patients were randomly allocated to either the control group (n=2701) or the remote ischaemic conditioning group (n=2700). After exclusion of patients upon hospital arrival or loss to follow-up, 2569 patients in the control group and 2546 in the intervention group were included in the intention-to-treat analysis. At 12 months post-PPCI, the Kaplan-Meier-estimated frequencies of cardiac death or hospitalisation for heart failure (the primary endpoint) were 220 (8·6%) patients in the control group and 239 (9·4%) in the remote ischaemic conditioning group (hazard ratio 1·10 [95% CI 0·91-1·32], p=0·32 for intervention versus control). No important unexpected adverse events or side effects of remote ischaemic conditioning were observed. INTERPRETATION: Remote ischaemic conditioning does not improve clinical outcomes (cardiac death or hospitalisation for heart failure) at 12 months in patients with STEMI undergoing PPCI. FUNDING: British Heart Foundation, University College London Hospitals/University College London Biomedical Research Centre, Danish Innovation Foundation, Novo Nordisk Foundation, TrygFonden
Clinical impact of customised positive airway pressure (PAP) therapy interfaces versus usual care in the treatment of patients with sleep-disordered breathing (3DPiPPIn): a randomised controlled trial protocol
No full textIntroduction Sleep-disordered breathing affects 1.6 million people in the UK. The recognised treatment is positive airway pressure (PAP) therapy, delivered via a generic conventional interface (mask). PAP therapy improves morbidity, mortality and quality of life, but treatment effectiveness depends on interface fit and tolerance. Interface side effects include pressure ulcers, skin reactions and interface leak. Three-dimensional (3D) printing is an innovative technology that can produce customised interfaces.Aims The primary aim is to assess the impact of customised versus conventional interfaces on residual Apnoea Hypopnea Index at 6 months.Methods and analysis This is a randomised control trial via block randomisation, minimised by age >65 and ethnicity, using a computerised random number generator. Patients with sleep-disordered breathing under the care of the Royal Free London NHS Foundation Trust will be recruited. Patients new to therapy will be randomised to customised interface or conventional interface for 6 months. A sample size of 160 is required for 80% power with a significance of 5%, accounting for a 20% dropout rate. Descriptive statistics will report demographics. The primary and secondary outcomes will be compared using linear regression adjusted for baseline score.Ethics and dissemination This protocol has been approved by the Hampshire B Research Ethics Committee (REC reference: 22/SC/0405). Results will be disseminated to healthcare professionals and patients through conferences, open-access journals, newsletters, a study webpage, infographics, animations, social media and healthcare awards.ISRCTN registration number 74082423
Rehabilitation using virtual gaming for Hospital and hOMe-Based training for the Upper limb post Stroke (RHOMBUS II): protocol of a feasibility randomised controlled trial
Get PDFThe Stroke Association and MedCity grant number SA MC 21\10001
