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Cantwell M, Moyna N, McCaffrey N, Skelly F, Loughney L, Woods C, Walsh D, Dowd K, McCarren A, Kehoe B. A two-arm non-randomised trial of MedEx IMPACT: a community-based, physical activity behaviour change intervention for survivors of cancer. Support Care Cancer 2024; 32:95. [PMID: 38198017 DOI: 10.1007/s00520-023-08263-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 12/16/2023] [Indexed: 01/11/2024]
Abstract
PURPOSE This two-arm non-randomised trial examined the short- and long-term effects of a usual care (UC) community-based exercise programme (MedEx Move On (MMO)), and UC combined with a physical activity (PA) behaviour change (BC) intervention (MedEx IMproved PA after Cancer Treatement (MedEx IMPACT)) on PA levels, cardiorespiratory fitness (CRF) and quality of life (QoL) among survivors of cancer. METHODS Cancer survivors referred to MMO were recruited (n = 191; mean age (± SD) 56 (± 10y), 73% female). Eighty-seven participants were assigned to UC, and 104 participants were assigned to the MedEx IMPACT intervention group (MI). UC and MI both received twice-weekly supervised exercise classes for 12-weeks. MI also received an independent PA programme, 4 PA information sessions and a 1:1 exercise consultation during the 12-week programme. Assessments of physical and psycho-social health, including 6-day accelerometry, the 6-min time trial and the Functional Assessment of Cancer Therapy-General QoL questionnaire, were conducted at baseline (T1), post-intervention (T2) and 3 months following programme completion (T3). RESULTS Linear mixed-model analyses of variance demonstrated significant main effects for time for both groups from T1 to T2 with increases in objectively measured daily steps (p < 0.05), CRF (p < .001) and QoL (p < .01), which were maintained for CRF (p < .001) at T3. MI participants also maintained increases achieved at T2, in steps and QoL, at T3 (p < 0.01). CONCLUSION Twelve weeks of twice-weekly supervised exercise was effective in increasing PA, CRF and QoL among survivors of cancer. MI resulted in the maintenance of all improvements achieved 3 months following programme completion.
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Affiliation(s)
- Mairéad Cantwell
- Department of Sport and Health Sciences, Technological University of the Shannon: Midlands Midwest, University Road, Athlone, Co. Westmeath, Ireland.
- School of Health and Human Performance, Dublin City University, Dublin, Ireland.
- Irish Cancer Society, Dublin, Ireland.
| | - Niall Moyna
- School of Health and Human Performance, Dublin City University, Dublin, Ireland
| | - Noel McCaffrey
- MedEx Wellness, School of Health & Human Performance, Dublin City University; ExWell Medical, Dublin, Ireland
| | - Fiona Skelly
- Department of Sport and Health Sciences, Technological University of the Shannon: Midlands Midwest, University Road, Athlone, Co. Westmeath, Ireland
- School of Health and Human Performance, Dublin City University, Dublin, Ireland
- MedEx Wellness, School of Health & Human Performance, Dublin City University; ExWell Medical, Dublin, Ireland
| | - Lisa Loughney
- School of Health and Human Performance, Dublin City University, Dublin, Ireland
| | - Catherine Woods
- Health Research Institute, Department of Physical Education and Sport Sciences, University of Limerick, Limerick, Ireland
| | - Deirdre Walsh
- School of Health and Human Performance, Dublin City University, Dublin, Ireland
- Department of Social Sciences, Technological University of the Shannon: Midlands Midwest, Athlone, Ireland
| | - Kieran Dowd
- Department of Sport and Health Sciences, Technological University of the Shannon: Midlands Midwest, University Road, Athlone, Co. Westmeath, Ireland
| | - Andrew McCarren
- School of Computing, Dublin City University, Dublin, Ireland
| | - Bróna Kehoe
- School of Health and Human Performance, Dublin City University, Dublin, Ireland
- Department of Sport and Exercise Science, South East Technological University, Waterford, Ireland
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Murphy K, Kehoe B, Denieffe S, Hacking D, Fairman CM, Harrison M. A comparison of aerobic- and resistance-emphasised exercise on cardiometabolic health and quality of life in men receiving androgen deprivation therapy for prostate cancer: Protocol for a feasibility trial. Contemp Clin Trials 2024; 136:107388. [PMID: 37972755 DOI: 10.1016/j.cct.2023.107388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 10/15/2023] [Accepted: 11/11/2023] [Indexed: 11/19/2023]
Abstract
BACKGROUND Those with intermediate and high-risk prostate cancer typically receive androgen deprivation therapy (ADT) as part of their treatment. ADT often results in extensive side effects including increased risk of cardiometabolic disease. Many ADT side effects can be influenced by exercise, both resistance and aerobic training. Exercise regimes typically combine aerobic and resistance exercise but the appropriate emphasis for achieving the broadest range of therapeutic benefits has yet to be determined. We propose to determine the feasibility of undertaking a larger trial comparing a resistance- vs an aerobic-emphasised exercise intervention in men with prostate cancer undergoing ADT. The trial will also investigate preliminary evidence of difference between arms for cardiometabolic health and quality of life outcomes. METHODS This is a 6-month randomised two-armed feasibility trial. Prostate cancer patients undergoing ADT and radiotherapy will be recruited (n = 24) and randomised to either a resistance- or aerobic-emphasised group. Participants will attend twice-weekly supervised individual or small group sessions, with 75% of exercise time in the primary exercise modality. The primary outcome will be feasibility, determined via assessment of recruitment, retention, adherence, safety, and acceptability. Secondary outcomes will include quality of life, body composition, vascular indices, aerobic and muscular fitness and cardiometabolic health blood biomarkers. CONCLUSION It is envisaged that the trial will provide valuable information and preliminary difference data that will aid in the design of an efficacious larger trial that will adopt a major and minor emphasis approach to the scheduling of resistance and aerobic exercise.
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Affiliation(s)
- Kira Murphy
- Department of Sport and Exercise Science, South East Technological University, Waterford, Ireland; UPMC Hillman Cancer Center, Whitfield Hospital, Waterford, Ireland
| | - Bróna Kehoe
- Department of Sport and Exercise Science, South East Technological University, Waterford, Ireland
| | - Suzanne Denieffe
- School of Humanities, South East Technological University, Waterford, Ireland
| | - Dayle Hacking
- UPMC Hillman Cancer Center, Whitfield Hospital, Waterford, Ireland
| | - Ciaran M Fairman
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Michael Harrison
- Department of Sport and Exercise Science, South East Technological University, Waterford, Ireland.
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Murphy K, Denieffe S, Kehoe B, Hacking D, Fairman CM, Harrison M. Designing effective exercise intervention trials for prostate cancer cohorts: a qualitative study on experiences and views of exercise oncology researchers. BMC Sports Sci Med Rehabil 2023; 15:145. [PMID: 37904240 PMCID: PMC10614306 DOI: 10.1186/s13102-023-00756-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 10/21/2023] [Indexed: 11/01/2023]
Abstract
BACKGROUND Exercise intervention research has shown promising results in preventing and reversing the side effects caused by prostate cancer and its' treatment. However, there are still unanswered questions and the need for additional research. As the field of exercise oncology in the context of prostate cancer presents unique challenges and complexities, seeking the advice of experienced exercise oncology researchers before initiating a similar trial could help to design more effective and efficient studies and help avoid pitfalls. METHODS A qualitative descriptive study design and a nonprobability, purposive sampling method was employed. An interview guide was developed and included topics such as recruitment, retention, programme goals, research design, health considerations, treatment considerations, adverse events, exercise prescription and outcome tools. Individual semi-structured interviews were conducted and interviews were transcribed and analysed using thematic analysis. RESULTS Eight individuals with extensive experience working with prostate cancer patients in exercise oncology research settings were interviewed. Four main themes and seven subthemes were generated and supported by the data. Theme 1 highlighted the critical role of recruitment, with associated subthemes on recruitment barriers and recruitment methods. Theme 2 explored the positives and negatives of home-based programmes. Theme 3 focused on specific health characteristics, exercise prescription and outcome measure factors that must be considered when working with prostate cancer cohorts. Finally, theme 4 centered around the emotional dimensions present in exercise oncology trials, relating to both researchers and study participants. CONCLUSION Exercise oncology remains a challenging area in which to conduct research. Learning from experienced personnel in the field offers valuable information and guidance that could impact the success of future trials.
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Affiliation(s)
- Kira Murphy
- Department of Sport and Exercise Science, South East Technological University, Waterford, Ireland
- UPMC Hillman Cancer Center, Whitfield Hospital, Waterford, Ireland
| | - Suzanne Denieffe
- School of Humanities, South East Technological University, College Street Campus, Waterford, Ireland.
| | - Bróna Kehoe
- Department of Sport and Exercise Science, South East Technological University, Waterford, Ireland
| | - Dayle Hacking
- UPMC Hillman Cancer Center, Whitfield Hospital, Waterford, Ireland
| | - Ciaran M Fairman
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Michael Harrison
- Department of Sport and Exercise Science, South East Technological University, Waterford, Ireland
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O'Keeffe E, Landers S, Kehoe B, Davey N, Cooke J. 307 THE FEASIBILITY OF USING AN INCLINOMETER TO PROVIDE OLDER HOSPITALISED PATIENTS WITH FEEDBACK ON THEIR ACTIVITY LEVELS. Age Ageing 2022. [DOI: 10.1093/ageing/afac218.270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Low levels of physical activity in older adults are well documented and have been associated with functional decline, acute sarcopenia, prolonged length of stay and higher readmission rates. Interventions to modify behaviour in hospitalised older adults include providing feedback on performance. Commercially available activity trackers and pedometers which rely on step count, are often unable to detect steps at the walking speeds found in older hospitalised patients. This study investigated the feasibility of using an inclinometer to measure the time spent by older hospitalised adults in lying and sitting versus standing and walking, and to provide feedback to patients on their active versus sedentary levels.
Methods
This was a feasibility study using a cross-sectional single centre design. Twelve inpatients over 70 years of age were fitted with an ActivPAL accelerometer on their thigh, which was worn continuously for 3 days. A graphic display of sedentary versus active time was provided to the participants each morning. Acceptability of wearing the device and receiving feedback was determined using a modified technology acceptance questionnaire.
Results
Twelve hospitalised older adults (7 female, 5 male) were included in the study, median age 74 (66-84). A modified technology questionnaire showed that 83% of participants found the ActivPAL device comfortable to wear, 100% reported that the feedback from the device was clear and understandable and 92% reported that the information enhanced their motivation for physical activity and that they would wear the device again.
Conclusion
This feasibility study shows that the ActivPAL is a device that can be worn in the hospital setting to provide older adults with feedback on their activity levels in order to modify behaviour and increase their levels of physical activity while in hospital.
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Affiliation(s)
- E O'Keeffe
- Universtity Hospital Waterford , Waterford, Ireland
| | - S Landers
- Universtity Hospital Waterford , Waterford, Ireland
| | - B Kehoe
- Waterford Institute of Technology , Waterford, Ireland
| | - N Davey
- Universtity Hospital Waterford , Waterford, Ireland
| | - J Cooke
- Universtity Hospital Waterford , Waterford, Ireland
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Cantwell M, Kehoe B, Moyna N, McCaffrey N, Skelly F, Loughney L, Walsh DMJ, Dowd K, McCarren A, Woods C. Study protocol for the investigation of the clinical effectiveness of a physical activity behaviour change intervention for individuals living with and beyond cancer. Contemp Clin Trials Commun 2022; 26:100882. [PMID: 35265769 PMCID: PMC8898780 DOI: 10.1016/j.conctc.2021.100882] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 11/15/2021] [Accepted: 12/23/2021] [Indexed: 11/30/2022] Open
Abstract
Most individuals living with and beyond cancer are not sufficiently active to achieve the health benefits associated with regular physical activity (PA). The purpose of this study was to describe the study protocol for a two-arm non-randomised comparison trial conducted within a community-based setting, which aimed to investigate the clinical effectiveness of a cancer-specific PA behaviour change (BC) intervention, namely MedEx IMPACT (IMprove Physical Activity after Cancer Treatment), compared to a general exercise rehabilitation programme, among survivors of cancer. Individuals who had completed active-cancer treatment who were referred to a community-based exercise rehabilitation programme were invited to participate in the trial. Participants in the control group (CG) attended twice-weekly supervised exercise classes for 12 weeks. Classes were delivered as part of a chronic illness exercise rehabilitation programme. Participants in the MedEx IMPACT intervention group (IG) also attended the twice-weekly supervised exercise classes for 12 weeks and received cancer-specific materials, namely an independent PA programme, 4 PA information sessions and a 1:1 exercise consultation. The primary outcome was PA levels measured by 6-day accelerometry and self-report PA. Secondary outcomes included cardiorespiratory fitness (CRF), quality of life (QoL) and sedentary behaviour. Outcomes were measured at baseline and months 3, 6 and 12. Few effective PA BC interventions for individuals living with and beyond cancer have been identified. The results of this study will have implications for the planning and provision of community-based exercise oncology rehabilitation programmes for individuals living with and beyond cancer.
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Affiliation(s)
- Mairéad Cantwell
- Department of Sport and Health Sciences, Technological University of the Shannon: Midlands Midwest, University Road, Athlone, Co Westmeath, Ireland
- School of Health and Human Performance, Dublin City University, Ireland
- Irish Cancer Society, Ireland
- Corresponding author. Technological University of the Shannon: Midlands Midwest, University Road, Athlone, Co Westmeath, Ireland.
| | - Bróna Kehoe
- Department of Sport and Exercise Science, Waterford Institute of Technology, Ireland
| | - Niall Moyna
- School of Health and Human Performance, Dublin City University, Ireland
| | - Noel McCaffrey
- MedEx Wellness, School of Health & Human Performance, Dublin City University, ExWell Medical, Ireland
| | - Fiona Skelly
- Department of Sport and Health Sciences, Technological University of the Shannon: Midlands Midwest, University Road, Athlone, Co Westmeath, Ireland
- MedEx Wellness, School of Health & Human Performance, Dublin City University, ExWell Medical, Ireland
| | - Lisa Loughney
- MedEx Wellness, School of Health & Human Performance, Dublin City University, ExWell Medical, Ireland
| | - Deirdre MJ. Walsh
- Department of Social Science and Design, Technological University of the Shannon: Midlands Midwest, Ireland
| | - Kieran Dowd
- Department of Sport and Health Sciences, Technological University of the Shannon: Midlands Midwest, University Road, Athlone, Co Westmeath, Ireland
| | | | - Catherine Woods
- Health Research Institute, Department of Physical Education and Sport Sciences, University of Limerick, Ireland
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Malone SM, Kehoe B, Plunkett D, Loughney L, McCaffrey N, Redmond K, Moyna N. Selected Indices Of Physical And Psychological Health Of Lung Cancer Patients Scheduled For Surgery. Med Sci Sports Exerc 2021. [DOI: 10.1249/01.mss.0000764904.33085.f5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Hurley N, Moyna NM, Kehoe B, McCaffrey N, Redmond K, Hardcastle SJ. Factors influencing physical activity in adults with cystic fibrosis. BMC Pulm Med 2021; 21:113. [PMID: 33810783 PMCID: PMC8017094 DOI: 10.1186/s12890-021-01482-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Accepted: 03/26/2021] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND Physical activity (PA) is a well-documented and accepted adjunct therapy for the maintenance and improvement of long-term health in cystic fibrosis (CF). Although the benefits of PA for CF populations are well-established, adherence to PA programmes within this population remains low. This study aimed to investigate the factors that influence engagement in physical activity, and to explore exercise preferences, among adults with cystic fibrosis (CF). METHODS Semi-structured telephone interviews were conducted. Participants were twenty-one adults (mean age 35 years, SD ± 8) with an established diagnosis of CF, living in Ireland. Interview scripts were digitally recorded and transcribed verbatim. Thematic analysis was used to analyse the data. RESULTS Four main themes emerged: barriers, motives, value of exercise-related outcomes, and exercise preferences. The main barriers included: low energy levels, time, the weather, and exercise-related confidence. Enjoyment and perceived competence underpinned autonomous motivation. Participants who self-identified as being regularly active valued personally identified exercise-related outcomes such as, accomplishment and affect regulation. Participants indicated a preference for home-based physical activity programs compared to gym- or facility-based programs. CONCLUSION Interventions aimed at promoting physical activity among adults with CF should involve programs that foster autonomous motivation, enjoyable activities, personally identified outcomes, competence and that can be conducted from the home environment. CLINICAL IMPLICATIONS To increase physical activity participation among adults with CF, interventions that can be conducted from the home environment, that pay attention to the patients' personally-valued exercise outcomes may be required.
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Affiliation(s)
- Nicola Hurley
- School of Health and Human Performance, Faculty of Science and Health, Dublin City University, Dublin 9, Ireland.
| | - Niall M Moyna
- School of Health and Human Performance, Faculty of Science and Health, Dublin City University, Dublin 9, Ireland
| | - Bróna Kehoe
- Department of Sport and Exercise Science, Waterford Institute of Technology, Waterford, Ireland
| | - Noel McCaffrey
- ExWell, Chronic Illness Rehabilitation Centre, Dublin, Ireland
| | - Karen Redmond
- Mater Misericordiae University Hospital, Dublin, Ireland
| | - Sarah J Hardcastle
- School of Health and Human Performance, Faculty of Science and Health, Dublin City University, Dublin 9, Ireland
- Institute for Health Research, University of Notre Dame Australia, Fremantle, Australia
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Hurley N, Kehoe B, McCaffrey N, Redmond K, Cullen L, Moyna NM. Recommendations to improve physical activity prescription for the cystic fibrosis population: an Irish perspective. BMC Health Serv Res 2020; 20:1052. [PMID: 33213453 PMCID: PMC7678110 DOI: 10.1186/s12913-020-05910-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Accepted: 11/09/2020] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Physical activity (PA) is a well-established therapeutic modality for the maintenance and improvement of long-term health in cystic fibrosis (CF). Healthcare professionals (HCP) are considered credible and well-placed messengers for the delivery of PA advice. Limited research exists investigating the extent of PA prescription within CF care. This study aimed to identify Irish HCP i) knowledge and practice of, and ii) motivators and barriers to PA prescription, and iii) proposed strategies to optimize PA promotion and prescription in CF populations. METHODS HCP from six designated CF centres in Ireland and members of the national physiotherapy CF clinical interest group were invited to participate. Following an expression of interest, each HCP (n = 81) received an email containing the plain language statement and link to the online survey. 48 HCP (physiotherapists n = 24, other n = 24) completed the 30-item investigator-developed survey, which included multiple choice single answer, matrix style and open-ended questions. RESULTS Most HCP (81%) acknowledged that discussing PA with CF patients was part of their professional role. Almost all physiotherapists (95%) reported having sufficient knowledge regarding PA prescription, compared to 17% of other HCP. All physiotherapists reported discussing PA at every patient interaction, with 81% employing the current consensus guidelines, compared to 33 and 5% of other HCP, respectively. Among the most common barriers reported by HCP to recommending PA to their CF patients were; lack of motivation and compliance among patients to adhere to PA advice, limited availability of PA programmes to refer their patients to, limited time with patients during clinic visits and a lack of knowledge regarding PA prescription for CF care. Three-quarters of HCP reported a need to improve PA services for CF patients in Ireland. CONCLUSION As people with CF are living longer, it is imperative that HCP are expanding their scope of practice to include discussions around PA at every patient visit. Formal educational opportunities in the form of continuing professional development programmes are warranted for CF HCP to optimize long-term patient management and outcomes. There is also a need to develop patient-centered and evidence-based PA programmes underpinned by theories of behaviour change to enhance motivation and compliance among CF patients.
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Affiliation(s)
- Nicola Hurley
- School of Health and Human Performance, Dublin City University, Dublin, Ireland.
| | - Bróna Kehoe
- Department of Sport and Exercise Science, Waterford Institute of Technology, Waterford, Ireland
| | | | - Karen Redmond
- Mater Misericordiae University Hospital, Dublin, Ireland
| | | | - Niall M Moyna
- School of Health and Human Performance, Dublin City University, Dublin, Ireland
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Kehoe B, Skelly F, Moyna N, Cantwell M, Boran L, Daly L, McCarren A, Dowd K, Woods C, McCaffrey N, Loughney L. The effect of participating in MedEx Wellness, a community-based chronic disease exercise rehabilitation programme, on physical, clinical and psychological health: A study protocol for a cohort trial. Contemp Clin Trials Commun 2020; 19:100591. [PMID: 32685764 PMCID: PMC7358260 DOI: 10.1016/j.conctc.2020.100591] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Revised: 06/08/2020] [Accepted: 06/14/2020] [Indexed: 01/07/2023] Open
Abstract
Background Community-based exercise rehabilitation programmes for chronic disease are an effective alternative to traditional hospital-based programmes. MedEx Wellness is a novel community-based exercise rehabilitation programme that integrates a range of chronic diseases. The aim of this trial was to investigate the effect of participating in MedEx Wellness on physical, clinical and psychological health. Methods A prospective cohort study was conducted. Participants were recruited at induction to the MedEx Wellness programme following referral from healthcare professionals. Participants underwent a baseline assessment before commencing the exercise programme and repeat assessments at 3, 6 and 12 months. The primary outcome was cardiorespiratory fitness (6 minute- time trial) at 12 months. Secondary outcomes included health-related quality of life (EuroQoL-5D, Satisfaction with Life Scale, Warwick Edinburgh Mental Wellbeing Scale, Patient Health Questionnaire8, Functional Assessment of Cancer Therapy Questionnaire), free living activity behavior (accelerometer) and healthcare utilization (recall questionnaire). Tertiary outcomes included blood pressure (24 h), biomarkers (lipids, glucose and C-reactive protein), other components of physical fitness, including strength (handgrip test, sit-to-stand test), flexibility (sit-and-reach test), body composition (body mass index and waist-to-hip ratio), and falls risk (timed up and go test), and claudication time (incremental treadmill walking test), cognitive function, including attention (Attention Network Task), memory (Luck & Vogel Visual Working Memory Task) and cognitive reserve. Exploratory outcomes included psychosocial determinants of physical activity (self-efficacy, social support, intentions). Discussion This trial will evaluate whether participation in the MedEx Wellness programme has positive effects on physical, clinical and psychological health in individuals with a range of chronic diseases. Trial registration ISRCTN Registry ISRCTN10351412.
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Affiliation(s)
- Bróna Kehoe
- MedEx Wellness, School of Health & Human Performance, Dublin City University, Dublin, Ireland
| | - Fiona Skelly
- MedEx Wellness, School of Health & Human Performance, Dublin City University, Dublin, Ireland
| | - Niall Moyna
- MedEx Wellness, School of Health & Human Performance, Dublin City University, Dublin, Ireland
| | - Mairéad Cantwell
- MedEx Wellness, School of Health & Human Performance, Dublin City University, Dublin, Ireland
| | - Lorraine Boran
- School of Psychology, Dublin City University, Dublin, 9, Ireland
| | - Leslie Daly
- School of Public Health, Physiotherapy & Sports Science, University College Dublin, Dublin, Ireland
| | - Andrew McCarren
- School of Computing, Dublin City University, Dublin, Ireland
| | - Kieran Dowd
- Department of Sport & Health Sciences, Athlone Institute of Technology, Athlone, Westmeath, Ireland
| | - Catherine Woods
- Physical Activity for Health, Health Research Institute, Department of Physical Education and Sport Sciences, University of Limerick, Limerick, Ireland
| | - Noel McCaffrey
- MedEx Wellness, School of Health & Human Performance, Dublin City University, Dublin, Ireland
| | - Lisa Loughney
- MedEx Wellness, School of Health & Human Performance, Dublin City University, Dublin, Ireland
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McCabe L, Kehoe B. DI-016 Development of a quick reference guide for syringe driver drug compatibilities. Eur J Hosp Pharm 2015. [DOI: 10.1136/ejhpharm-2015-000639.194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Kehoe B. CP-021 Incorporation of the stopp criteria into clinical pharmacy practice. Eur J Hosp Pharm 2015. [DOI: 10.1136/ejhpharm-2015-000639.21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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12
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Griffin J, Brauning N, Kehoe B, Poonoosamy S. A competency-based orientation tool for initial orientation to the care of blood and marrow transplantation patients. Biol Blood Marrow Transplant 2005. [DOI: 10.1016/j.bbmt.2004.12.312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Belcher CE, Drenkow J, Kehoe B, Gingeras TR, McNamara N, Lemjabbar H, Basbaum C, Relman DA. The transcriptional responses of respiratory epithelial cells to Bordetella pertussis reveal host defensive and pathogen counter-defensive strategies. Proc Natl Acad Sci U S A 2000; 97:13847-52. [PMID: 11087813 PMCID: PMC17664 DOI: 10.1073/pnas.230262797] [Citation(s) in RCA: 127] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Bordetella pertussis, the causative agent of whooping cough, has many well-studied virulence factors and a characteristic clinical presentation. Despite this information, it is not clear how B. pertussis interaction with host cells leads to disease. In this study, we examined the interaction of B. pertussis with a human bronchial epithelial cell line (BEAS-2B) and measured host transcriptional profiles by using high-density DNA microarrays. The early transcriptional response to this pathogen is dominated by altered expression of cytokines, DNA-binding proteins, and NFkappaB-regulated genes. This previously unrecognized response to B. pertussis was modified in similar but nonidentical fashions by the antiinflammatory agents dexamethasone and sodium salicylate. Cytokine protein expression was confirmed, as was neutrophil chemoattraction. We show that B. pertussis induces mucin gene transcription by BEAS-2B cells then counters this defense by using mucin as a binding substrate. A set of genes is described for which the catalytic activity of pertussis toxin is both necessary and sufficient to regulate transcription. Host genomic transcriptional profiling, in combination with functional assays to evaluate subsequent biological events, provides insight into the complex interaction of host and pathogen.
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Affiliation(s)
- C E Belcher
- Departments of Pediatrics, Microbiology and Immunology, and Medicine, Stanford University, Stanford, CA 94305, USA
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Zipser D, Kehoe B, Littlewort G, Fuster J. A spiking network model of short-term active memory. J Neurosci 1993; 13:3406-20. [PMID: 8340815 PMCID: PMC6576542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
Studies of cortical neurons in monkeys performing short-term memory tasks have shown that information about a stimulus can be maintained by persistent neuron firing for periods of many seconds after removal of the stimulus. The mechanism by which this sustained activity is initiated and maintained is unknown. In this article we present a spiking neural network model of short-term memory and use it to investigate the hypothesis that recurrent, or "re-entrant," networks with constant connection strengths are sufficient to store graded information temporarily. The synaptic weights that enable the network to mimic the input-output characteristics of an active memory module are computed using an optimization procedure for recurrent networks with non-spiking neurons. This network is then transformed into one with spiking neurons by interpreting the continuous output values of the nonspiking model neurons as spiking probabilities. The behavior of the model neurons in this spiking network is compared with that of 179 single units previously recorded in monkey inferotemporal (IT) cortex during the performance of a short-term memory task. The spiking patterns of almost every model neuron are found to resemble closely those of IT neurons. About 40% of the IT neuron firing patterns are also found to be of the same types as those of model neurons. A property of the spiking model is that the neurons cannot maintain precise graded activity levels indefinitely, but eventually relax to one of a few constant activities called fixed-point attractors. The noise introduced into the model by the randomness of spiking causes the network to jump between these attractors. This switching between attractor states generates spike trains with a characteristic statistical temporal structure. We found evidence for the same kind of structure in the spike trains from about half of the IT neurons in our test set. These results show that the behavior of many real cortical memory neurons is consistent with an active storage mechanism based on recurrent activity in networks with fixed synaptic strengths.
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Affiliation(s)
- D Zipser
- Department of Cognitive Science, University of California, San Diego, La Jolla 92093
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Abstract
Elevated plasma renin activity (PRA) has been documented in patients with established acute renal failure. To study the association of PRA and renal dysfunction, 53 patients who were at risk of developing acute renal failure had serial measurements of PRA, renal function, and urinary beta 2-microglobulin. Those entered for study had pneumonia, septicaemia, volume loss with hypotension, or major surgical procedures with complications. Patients were divided into groups of abnormal or normal renal function. Abnormal renal function was defined by an elevated plasma urea and/or creatinine level with a submaximal urine urea to plasma urea ratio. The mean values of PRA for the abnormal and normal renal function groups, respectively, were 29 and 5.2 ng/ml/h (p less than 0.0001) and for beta 2-microglobulin 16.2 and 6.4 micrograms/l X 10(3) (p less than 0.0005). A linear regression of the logs of PRA to beta 2-microglobulin for the total group of patients gave an r value of 0.526 (p less than 0.001). These data show an association of PRA to renal dysfunction and tubular injury/dysfunction in the prerenal phase of renal failure, suggesting an effect of the renin-angiotensin system at this phase. It is not possible, however, to conclude from our study that the renin-angiotensin system has a direct role in the development of established acute tubular necrosis, since only 3 patients fell within this category.
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Abstract
Fifty-nine community-acquired pneumonias were treated in a randomized double blind trial with cefamandole or ceftazidime. A prospective scoring system was used to define severity. This made use of basic clinical data, associated diseases, white blood count, blood gases and chest radiographs. There were no serious side-effects from the drugs. There were two deaths and six failed treatment. The scoring system which defined an 'ill group' showed as good a response of these ill patients to the new cephalosporin, ceftazidime as to cefamandole.
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Martin GL, Kehoe B, Bird E, Jensen V, Darbyshire M. Operant conditioning in dressing behavior of severely retarded girls. Ment Retard 1971; 9:27-31. [PMID: 5558456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
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Abrams GS, Glasser RG, Kehoe B, Sechi-Zorn B, Wolsky G. Final States with Two or More Strange Particles from4.25−BeVcK−pInteractions. ACTA ACUST UNITED AC 1968. [DOI: 10.1103/physrev.175.1697] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Courant H, Filthuth H, Franzini P, Minguzzi-Ranzi A, Segar A, Engelmann R, Hepp V, Kluge E, Burnstein RA, Day TB, Glasser RG, Herz AJ, Kehoe B, Sechi-Zorn B, Seeman N, Snow GA, Willis W. Leptonic Decays of ChargedΣHyperons and theΔS=ΔQSelection Rule. ACTA ACUST UNITED AC 1964. [DOI: 10.1103/physrev.136.b1791] [Citation(s) in RCA: 29] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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