Assessing Communities of Practice in health policy : A conceptual framework as a first step towards empirical research

Peer reviewe

The relationships between golf and health:A scoping review

OBJECTIVE: To assess the relationships between golf and health. DESIGN: Scoping review. DATA SOURCES: Published and unpublished reports of any age or language, identified by searching electronic databases, platforms, reference lists, websites and from consulting experts. REVIEW METHODS: A 3-step search strategy identified relevant published primary and secondary studies as well as grey literature. Identified studies were screened for final inclusion. Data were extracted using a standardised tool, to form (1) a descriptive analysis and (2) a thematic summary. RESULTS AND DISCUSSION: 4944 records were identified with an initial search. 301 studies met criteria for the scoping review. Golf can provide moderate intensity physical activity and is associated with physical health benefits that include improved cardiovascular, respiratory and metabolic profiles, and improved wellness. There is limited evidence related to golf and mental health. The incidence of golfing injury is moderate, with back injuries the most frequent. Accidental head injuries are rare, but can have serious consequences. CONCLUSIONS: Practitioners and policymakers can be encouraged to support more people to play golf, due to associated improved physical health and mental well-being, and a potential contribution to increased life expectancy. Injuries and illnesses associated with golf have been identified, and risk reduction strategies are warranted. Further research priorities include systematic reviews to further explore the cause and effect nature of the relationships described. Research characterising golf's contribution to muscular strengthening, balance and falls prevention as well as further assessing the associations and effects between golf and mental health are also indicated

Mindfulness-based interventions for young offenders: a scoping review

Youth offending is a problem worldwide. Young people in the criminal justice system have frequently experienced adverse childhood circumstances, mental health problems, difficulties regulating emotions and poor quality of life. Mindfulness-based interventions can help people manage problems resulting from these experiences, but their usefulness for youth offending populations is not clear. This review evaluated existing evidence for mindfulness-based interventions among such populations. To be included, each study used an intervention with at least one of the three core components of mindfulness-based stress reduction (breath awareness, body awareness, mindful movement) that was delivered to young people in prison or community rehabilitation programs. No restrictions were placed on methods used. Thirteen studies were included: three randomized controlled trials, one controlled trial, three pre-post study designs, three mixed-methods approaches and three qualitative studies. Pooled numbers (n = 842) comprised 99% males aged between 14 and 23. Interventions varied so it was not possible to identify an optimal approach in terms of content, dose or intensity. Studies found some improvement in various measures of mental health, self-regulation, problematic behaviour, substance use, quality of life and criminal propensity. In those studies measuring mindfulness, changes did not reach statistical significance. Qualitative studies reported participants feeling less stressed, better able to concentrate, manage emotions and behaviour, improved social skills and that the interventions were acceptable. Generally low study quality limits the generalizability of these findings. Greater clarity on intervention components and robust mixed-methods evaluation would improve clarity of reporting and better guide future youth offending prevention programs

The Effects of a 5-Day Virtual-Reality Based Exercise Program on Kinematics and Postural Muscle Activity in Youth with Cerebral Palsy

Aims: To determine the effects of a 5-day virtual reality (VR)-based intervention on anticipatory and reactive mechanisms of postural control in children and adolescents with cerebral palsy (CP). Methods: Eleven youth with CP (GMFCS levels I and II), ages 7–17, were allocated to intervention (N = 5) and control (N = 6) groups. Both groups attended balance assessment sessions 1 week apart. Participants in the intervention group received 1-hour one-on-one physiotherapist-supervised VR balance games for 5 consecutive days between assessments. For balance assessments, participants stood erect with eyes open on a movable platform that translated progressively through four speeds in the anterior/posterior direction. Participants performed two trials each of experimenter-triggered and self-triggered perturbations. Postural muscle activity and kinematics were recorded. The Anchoring Index and body segment cross-correlations were calculated as an indication of body stabilization, and the number of steps taken to regain balance/avoid falling were counted. Mann–Whitney U tests for between group differences in change scores were undertaken with an accepted significance level of 0.01. Results: No consistent differences in change scores were identified between groups. Conclusions: There was no effect of a 5-day VR-based intervention on postural control mechanisms used in response to oscillating platform perturbations. Subsequent studies will further tailor VR interventions to patients’ functional balance needs

The use of the Nintendo Wii in motor rehabilitation for virtual reality interventions:a literature review

Several review articles have been published on the use of Virtual Reality (VR) in motor rehabilitation. The majority of these focus on the effectiveness of VR on improving motor function using relatively expensive commercial tools and technologies including robotics, cybergloves, cybergrasps, joysticks, force sensors and motion capture systems. However, we present the case in this chapter that game sensors and VR technologies which can be customized and reconfigured, such as the Nintendo Wii, provide an alternative and affordable VR intervention for rehabilitation. While the performance of many of the Wii based interventions in motor rehabilitation are currently the focus of investigation by researchers, an extensive and holistic discussion on this subject does not yet exist. As such, the purpose of this chapter is to provide readers with an understanding of the advantages and limitations of the Nintendo Wii game sensor device (and its associated accessories) for motor rehabilitation and in addition, to outline the potential for incorporating these into clinical interventions for the benefit of patients and therapists

Kinematics and postural muscular activity during continuous oscillating platform movement in children and adolescents with cerebral palsy

Background: Reactive and anticipatory postural activity has been described in single discrete perturbations in youth with cerebral palsy (CP) but not in continuous perturbation situations. Research Question: We sought to determine how the ability to control postural responses (as reflected in the number of steps taken, postural muscle activity, and marker-pair trajectory cross-correlations) compares between typically developing (TD) youth and age-matched youth with CP when exposed to various frequencies of continuous platform oscillation. We also sought to determine if youth with CP could further modify postural activity based on knowledge of platform movement. Methods: Eleven youth with CP and sixteen TD youth aged 7–17 years stood with eyes open on a movable platform progressively translated antero-posteriorly through four speeds in experimenter-triggered and self-triggered perturbations. Postural muscle activity and 3D kinematics were recorded. The Anchoring Index and marker-pair trajectories were used to quantify body stabilization strategies. Transition states and steady states were analysed. Mann Whitney-U tests analysed between-group differences at each frequency. Results: At lower frequencies (0.1 and 0.25 Hz) youth with CP behaved like age-matched TD controls. At higher frequencies (0.5 and 0.61 Hz), youth with CP took a greater number of steps, had a preference for stabilizing their head on the trunk, had low marker-pair correlations with high temporal lag, and showed increased tonic activity compared to their TD peers. Significance: Higher frequency platform movements proved more difficult for youth with CP, however, like TD youth, they shifted from reactive to anticipatory mechanisms when the platform frequency remained constant by taking advantage of knowledge of platform movement. When given control over perturbation onset, further evidence of anticipatory mechanisms was observed following the transition to a new oscillation frequency

A scoping study of interventions to increase the uptake of physical activity (PA) amongst individuals with mild-to-moderate depression (MMD)

Background - Depression is the largest contributor to disease burden globally. The evidence favouring physical activity as a treatment for mild-to-moderate depression is extensive and relatively uncontested. It is unclear, however, how to increase an uptake of physical activity amongst individuals experiencing mild-to-moderate depression. This leaves professionals with no guidance on how to help people experiencing mild-to-moderate depression to take up physical activity. The purpose of this study was to scope the evidence on interventions to increase the uptake of physical activity amongst individuals experiencing mild-to-moderate depression, and to develop a model of the mechanisms by which they are hypothesised to work. Methods - A scoping study was designed to include a review of primary studies, grey literature and six consultation exercises; two with individuals with experience of depression, two pre-project consultations with physical activity, mental health and literature review experts, one with public health experts, and one with community engagement experts. Results - Ten papers met the inclusion criteria and were included in the review. Consultation exercises provided insights into the mechanisms of an uptake of physical activity amongst individuals experiencing mild-to-moderate depression; evidence concerning those mechanisms is (a) fragmented in terms of design and purpose; (b) of varied quality; (c) rarely explicit about the mechanisms through which the interventions are thought to work. Physical, environmental and social factors that may represent mediating variables in the uptake of physical activity amongst people experiencing mild-to-moderate depression are largely absent from studies. Conclusions - An explanatory model was developed. This represents mild-to-moderate depression as interfering with (a) the motivation to take part in physical activity and (b) the volition that it is required to take part in physical activity. Therefore, both motivational and volitional elements are important in any intervention to increase physical activity in people with mild-to-moderate depression. Furthermore, mild-to-moderate depression-specific factors need to be tackled in any physical activity initiative, via psychological treatments such as Cognitive Behavioural Therapy. We argu

A Scoping Review of Home Produced Heroin and Amphetamine Type Stimulant Substitutes: Implications for Prevention, Treatment and Policy

Several home-produced substances such as krokodil and boltushka are prevalent in many Eastern European countries. Anecdotal reports of its use have been circulating in Germany and Norway; however, this has not been confirmed. Its use has also been reported by the media in the USA, although only one confirmed report of its use exists. Home-produced drugs are associated with high levels of morbidity and a number of complex health issues such as the spread of blood borne viruses, gangrene, and internal organ damage. The high incidence of HIV rates amongst people who inject home-produced substances is a public health concern. The resulting physical health consequences of injecting these crude substances are very severe in comparison to heroin or amphetamine acquired in black markets. Due to this fact and the increased mortality associated with these substances, professionals in the area of prevention, treatment, and policy development need to be cognisant of the presentation, harms, and the dangers associated with home-produced substances globally. This scoping review aimed to examine existing literature on the subject of home-produced heroin and amphetamine-type stimulant substitutes. The review discussed the many implications such research may have in the areas of policy and practice. Data were gathered through the use of qualitative secondary resources such as journal articles, reports, reviews, case studies, and media reports. The home production of these substances relies on the utilisation of precursor drugs such as less potent stimulants, tranquillizers, analgesics, and sedatives or natural plant ingredients. The Internet underpins the facilitation of this practice as recipes, and diverted pharmaceutical sales are available widely online, and currently, ease of access to the Internet is evident worldwide. This review highlights the necessity of prevention, education, and also harm reduction related to home-produced drugs and also recommends consistent monitoring of online drug fora, online drug marketplaces, and unregulated pharmacies

Quality of life among parents of preterm infants: a scoping review

Purpose: To synthesize the body of knowledge on the factors influencing the QoL of mothers and fathers of preterm infants. Methods: A scoping review was performed. Publications indexed in PubMed®, Web of Science™, CINAHL® and PsycINFO® were searched, targeting studies presenting original empirical data that examined parental perception on QoL after a preterm delivery. Eligibility and data extraction were conducted by two independent researchers. The main quantitative findings were synthesized and qualitative data were explored by content analysis. Results: The studies, 11 quantitative and 1 mixed methods, were derived mainly from the USA (n = 6). Heterogeneity across the studies was observed regarding the operationalization of QoL and the use of units of analysis (mothers, parents, families and caregivers). In a context where 40 out of 45 covariates were analysed by only one or two studies, results suggested that parental QoL after a preterm delivery is influenced by factors related with mother’s characteristics, family issues and health care environment rather than infants’ variables. Factors regarding fathers’ characteristics and structural levels were not addressed. Conclusions: Standardizing the operationalization of the QoL when analysing mothers and fathers of preterm infants calls for a structured questionnaire adapted to their specific needs. Further research should include both mothers and fathers, invest in mixed methods approaches and be performed in different countries and settings for allowing integration and comparison of findings.This work was supported by FEDER funding from the Operational Programme Factors of Competitiveness—COMPETE and by national funding from the Foundation for Science and Technology—FCT (Portuguese Ministry of Science, Technology and Higher Education) under the project “Parenting roles and knowledge in Neonatal Intensive Care Units” (FCOMP-01-0124-FEDER-019902; Ref. FCT PTDC/CS-ECS/120750/2010) and the Unidade de Investigação em Epidemiologia—Instituto de Saúde Pública da Universidade do Porto (EPIUnit) (POCI-01-0145-FEDER-006862; Ref. UID/DTP/04750/2013); the grants PD/BD/105830/2014 (to MA), SFRH/BPD/103562/2014 (to EA), co-funded by the FCT and the POPH/FSE Program and the FCT Investigator contract IF/01674/2015 (to SS)