BURA Community:
http://bura.brunel.ac.uk/handle/2438/8616
2024-03-28T08:55:58ZRethinking the relationship with the state
http://bura.brunel.ac.uk/handle/2438/28645
Title: Rethinking the relationship with the state
Authors: Asenjo, C
Abstract: This article explores the relationship between community work and the state in the UK in particular. By exploring the relevance and limitations of the book `In and against the state´, the article presents the idea that practitioners of community development can play a role in re-defining the role of the state by changing the discourse from `working in and against the state´ to `working for and as the state´. In this sense, constructing an ideological position regarding what the state should be and which role it should play could be equally as important as developing new approaches to practice in response to the influence of the state.2015-03-25T00:00:00ZQuantity and quality of airway clearance in children and young people with cystic fibrosis
http://bura.brunel.ac.uk/handle/2438/28625
Title: Quantity and quality of airway clearance in children and young people with cystic fibrosis
Authors: Raywood, E; Shannon, H; Filipow, N; Tanriver, G; Stanojevic, S; Kapoor, K; Douglas, H; O'Connor, R; Murray, N; Black, B; Main, E
Abstract: Children and young people with CF (CYPwCF) get advice about using positive expiratory pressure (PEP) or oscillating PEP (OPEP) devices to clear sticky mucus from their lungs. However, little is known about the quantity (number of treatments, breaths, or sets) or quality (breath pressures and lengths) of these daily airway clearance techniques (ACTs) undertaken at home. This study used electronic pressure sensors to record real time breath-by-breath data from 145 CYPwCF (6–16y) during routine ACTs over 2 months. ACT quantity and quality were benchmarked against individual prescriptions and accepted recommendations for device use. In total 742,084 breaths from 9,081 treatments were recorded. Individual CYPwCF maintained consistent patterns of ACT quantity and quality over time. Overall, 60% of CYPwCF did at least half their prescribed treatments, while 27% did fewer than a quarter. About 77% of pre-teens did the right number of daily treatments compared with only 56% of teenagers. CYPwCF usually did the right number of breaths. ACT quality (recommended breath length and pressure) varied between participants and depended on device. Breath pressures, lengths and pressure-length relationships were significantly different between ACT devices. PEP devices encouraged longer breaths with lower pressures, while OPEP devices encouraged shorter breaths with higher pressures. More breaths per treatment were within advised ranges for both pressure and length using PEP (30–31%) than OPEP devices (1–3%). Objective measures of quantity and quality may help to optimise ACT device selection and support CYPwCF to do regular effective ACTs.
Description: Supplementary materials are online at: https://www.sciencedirect.com/science/article/pii/S1569199322006865#sec0016 .2022-10-07T00:00:00ZThe impact of physical activity and exercise interventions for physical health in people with cystic fibrosis: protocol for a systematic review
http://bura.brunel.ac.uk/handle/2438/28624
Title: The impact of physical activity and exercise interventions for physical health in people with cystic fibrosis: protocol for a systematic review
Authors: Tomlinson, OW; Denford, S; Barker, AR; Schneiderman, JE; Campisi, ES; Douglas, H; Rand, S; McNarry, MA; Mackintosh, KA; Williams, CA
Abstract: Background:
Cystic fibrosis (CF) is a genetically inherited, life-limiting condition, affecting ~90,000 people globally. Physical activity (PA) and exercise form an integral component of CF management, and have been highlighted by the CF community as an area of interest for future research. Previous reviews have solely focused on PA or structured exercise regimens independent of one another, and thus a comprehensive assessment of the physical health benefits of all PA, including exercise, interventions, is subsequently warranted. Therefore, the purpose of this review is to evaluate the effects of both PA and exercise upon outcomes of physical health and healthcare utilisation in people with CF.
Methods:
A systematic review has been registered and reported in line with Preferred Reporting Items for Systematic Reviews and Meta-Analysis-P guidelines. This will include randomised control trials on the effects of PA and exercise, relative to usual treatment, upon people with CF. Primary outcomes will include variables associated with fitness, PA, lung health, inflammation, body composition, glycaemic control and patient-reported outcomes. Secondary outcomes will include adverse events and healthcare utilisation. Searches will be undertaken in Ovid MEDLINE, OVID EMBASE, PsychINFO, ERIC, SPORTDiscus, ASSIA, CCTR, CINHAL and Web of Science databases, and will be searched from date of inception onwards. Two reviewers will independently screen citations and abstracts, and full-texts, for inclusion and data extraction, respectively. Methodological quality will be assessed using the Cochrane Risk of Bias-2 tool. If feasible, random-effects meta-analyses will be conducted where appropriate. Additional analyses will explore potential sources of heterogeneity, such as age, sex, and disease severity.
Discussion:
This systematic review will build on previous research, by comprehensively assessing the impact of both PA and exercise upon physical health and healthcare utilisation in people with CF. Results of this review will be utilised to inform discussions that will ultimately result in a consensus document on the impact of physical activity and exercise for people with CF.
Systematic review registration:
PROSPERO CRD42020184411
Description: Availability of data and materials:
Data and materials will be made available from the Open Science Framework (doi: 10.17605/OSF.IO/SFGJQ).; Supplementary Information is available online at: https://systematicreviewsjournal.biomedcentral.com/articles/10.1186/s13643-021-01614-8#Sec17 .2021-02-26T00:00:00ZUsing reference equations to standardise incremental shuttle walk test performance in children and young people with chronic conditions and facilitate the evaluation of exercise capacity and disease severity
http://bura.brunel.ac.uk/handle/2438/28623
Title: Using reference equations to standardise incremental shuttle walk test performance in children and young people with chronic conditions and facilitate the evaluation of exercise capacity and disease severity
Authors: Filipow, N; Bladen, M; Raywood, E; Robinson, E; Chugh, D; Douglas, H; Thorpe, N; O'Connor, R; Murray, N; Main, E
Abstract: Aims: The aim was to evaluate whether standardised exercise performance during the incremental shuttle walk test (ISWT) can be used to assess disease severity in children and young people (CYP) with chronic conditions, through (1) identifying the most appropriate paediatric normative reference equation for the ISWT, (2) assessing how well CYP with haemophilia and cystic fibrosis (CF) perform against the values predicted by the best fit reference equation and (3) evaluating the association between standardised ISWT performance and disease severity.
Methods: A cross-sectional analysis was carried out using existing data from two independent studies (2018–2019) at paediatric hospitals in London,UK. CYP with haemophilia (n=35) and CF (n=134) aged 5–18 years were included. Published reference equations for standardising ISWT were evaluated through a comparison of populations, and Bland-Altman analysis was used to assess the level of agreement between distances predicted by each equation. Associations between ISWT and disease severity were assessed with linear regression.
Results: Three relevant reference equations were identified for the ISWT that standardised performance based on age, sex and body mass index (Vardhan, Lanza, Pinho). A systematic proportional bias of standardised ISWT was observed in all equations, most pronounced with Vardhan and Lanza; the male Pinho equation was identified as most appropriate. On average, CYP with CF and haemophilia performed worse than predicted by the Pihno equation, although the range was wide. Standardised ISWT, and not ISWT distance alone, was significantly associated with forced expiratory volume in 1 s in CYP with CF. Standardised ISWT in CYP with haemophilia was slightly associated with haemophilia joint health score, but this was not significant.
Conclusions: ISWT performance may be useful in a clinic to identify those with worsening disease, but only when performance is standardised against a healthy reference population. The development of validated global reference equations is necessary for more robust assessment.
Description: Data availability statement:
Data are available upon reasonable request. The data are stored at Great Ormond Street Hospital within the secure Digital Research Environment. Access is possible with permission from the corresponding author upon reasonable request.; Supplementary Data are available online at: https://bmjopen.bmj.com/highwire/filestream/313786/field_highwire_adjunct_files/0/bmjopen-2023-075733supp001_data_supplement.pdf .2024-03-08T00:00:00Z