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Athletes with autism spectrum disorder (ASD) experience lesser care for injuries and athletic trainers (ATs) report feeling unprepared to provide care competently for this population. Provision of sports-related care can be impacted by sensory differences associated with ASD such as hyper-reactivity to sensation or poor integration of sensory information. An in-depth review of the literature using the Strength of Recommendation Taxonomy (SORT) guidelines was used to identify articles that address the sensory features of autism for athletic trainers with the purpose of informing athletic trainers about the sensory features of ASD and to present the most current evidence-based recommendations for providing care to athletes with ASD and other neurodivergent individuals who present with sensory differences. Relevant articles were reviewed by four independent researchers and organized by theme. Key themes included use of sensory friendly or adapted environments, sensory kits, and informed communication strategies that acknowledge sensory differences. Providing individualized care for athletes with ASD and sensory features can improve the quality of and participation in sports for autistic persons.
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Background: Thrombotic thrombocytopenic purpura (TTP) is a rare, life-threatening thrombotic microangiopathy (TMA), characterized by ADAMTS-13 activity <10%. ADAMTS-13 activity assays are typically performed in reference laboratories with a turnaround time of several days. First-line treatment for TTP, therapeutic plasma exchange (TPE), typically starts while results are pending. The automated, on-demand HemosIL AcuStar ADAMTS-13 Activity assay provides results in under an hour, which could reduce unnecessary TPE use and associated costs. Objectives: To estimate the hospital budget impact in the United States, United Kingdom, and France of using a rapid ADAMTS-13 activity assay. Methods: We compared routine use of a rapid assay in adults with TMA with a scenario in which results take 3 days. Model structure and variables were based on published literature, plus survey and interviews of five clinicians from the three countries. Costs for the ADAMTS-13 activity assays and TPE were included. Results: Model results suggest that if an on-demand, rapid ADAMTS-13 activity assay is used, US, UK, and French hospitals could save $18 million, £1.2 million, and 1.6 million annually, respectively. This equates to $10 788, £3497, and 4700 saved per patient with TMA in the United States, United Kingdom, and France. The model is most sensitive to the exact split of diagnoses of TMA cases, as savings accrue from non-TTP diagnoses. Conclusions: In patients with TMA, use of a rapid, on-demand ADAMTS-13 activity assay such as the HemosIL AcuStar ADAMTS-13 Activity assay has the potential to be cost saving for hospitals.
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The studyHodkinson A, Kontopantelis E, Adeniji C, et al. Accelerometer- and pedometer-based physical activity interventions among adults with cardiometabolic conditions: a systematic review and meta-analysis JAMA Network Open 2019;2:e1912895.This study was funded by the NIHR School for Primary Care Research (project number 390 ESWG Workstream 3).To read the full NIHR Signal, go to: https://discover.dc.nihr.ac.uk/content/signal-000880/pedometers-can-help-people-get-more-active-as-part-of-an-exercise-programme.
Asunto(s)
Actigrafía/instrumentación , Ejercicio Físico , Terapia por Ejercicio , Humanos , Atención Primaria de SaludRESUMEN
The studyThe CRASH-3 Trial Collaborators. Effects of tranexamic acid on death, disability, vascular occlusive events and other morbidities in patients with acute traumatic brain injury (CRASH-3): a randomised, placebo-controlled trial. Lancet 2019;394:1713-23.This trial was funded by NIHR Health Technology Assessment Programme (project number 14/190/01), JP Moulton Charitable Trust, Department of Health and Social Care, Department for International Development, Global Challenges Research Fund, Medical Research Council, and the Wellcome Trust (Joint Global Health Trials scheme).To read the full NIHR Signal, go to: https://discover.dc.nihr.ac.uk/content/signal-000870/tranexamic-acid-following-mild-to-moderate-traumatic-brain-injury-is-safe-and-reduces-deaths.
Asunto(s)
Antifibrinolíticos , Lesiones Traumáticas del Encéfalo , Enfermedades Vasculares , Humanos , Evaluación de la Tecnología Biomédica , Ácido TranexámicoRESUMEN
The studyHewlett S, Almeida C, Ambler N, et al. Reducing arthritis fatigue impact: two-year randomised controlled trial of cognitive behavioural approaches by rheumatology teams (RAFT). Ann Rheum Dis 2019;78:465-72.Hewlett S, Almeida C, Ambler N, et al. Group cognitive behavioural programme to reduce the impact of rheumatoid arthritis fatigue: the RAFT RCT with economic and qualitative evaluations. Health Technol Assess 2019;23:57.This project was funded by the NIHR Health Technology Assessment Programme (project number 11/112/01).To read the full NIHR Signal, go to: https://discover.dc.nihr.ac.uk/content/signal-000860/group-cognitive-behavioural-courses-may-reduce-fatigue-from-rheumatoid-arthritis.
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Artritis Reumatoide/complicaciones , Terapia Cognitivo-Conductual/métodos , Fatiga/prevención & control , Fatiga/terapia , Psicoterapia de Grupo/métodos , Anciano , Femenino , Humanos , Masculino , Persona de Mediana EdadRESUMEN
The studyPalmer R, Dimairo M, Cooper C, et al. Self-managed, computerised speech and language therapy for patients with chronic aphasia post-stroke compared with usual care or attention control (Big CACTUS): a multicentre, single-blinded, randomised controlled trial. Lancet Neurol 2019;18:821-33.This project was funded by the NIHR Health Technology Assessment Programme (project number 12/21/01) and the Tavistock Trust for Aphasia.To read the full NIHR Signal, go to: https://discover.dc.nihr.ac.uk/content/signal-000864/after-a-stroke-computerised-speech-and-language-therapy-can-help-people-find-words.
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Afasia , Accidente Cerebrovascular , Atención , Humanos , Terapia del Lenguaje , HablaRESUMEN
The studyCleland LC, McComb L, Kee F, et al. Effects of 20 mph interventions on a range of public health outcomes: a meta-narrative evidence synthesis. J Transp Health 2019. doi:10.1016/j.jth.2019.100633This project was funded by the NIHR Policy Research Programme (project number 17/149/19).To read the full NIHR Signal, go to: https://discover.dc.nihr.ac.uk/content/signal-000853/twenty-mph-speed-zones-reduce-the-danger-to-pedestrians-and-cyclists.
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Accidentes de Tránsito/prevención & control , Conducción de Automóvil/legislación & jurisprudencia , Ciclismo/lesiones , Peatones , Heridas y Lesiones/prevención & control , Ciclismo/legislación & jurisprudencia , Humanos , Reino UnidoRESUMEN
The studyDambha-Miller H, Day AJ, Strelitz J, et al. Behaviour change, weight loss and remission of Type 2 diabetes: a community-based prospective cohort study. Diabet Med 2019. doi:10.1111/dme.14122This project was funded by the NIHR Health Technology Assessment Programme (project number 08/116/300) as well as the Wellcome Trust (grant number: G061895), the Epidemiology Unit programme (MC_UU_12015/4), and the National Health Service R&D support funding.To read the full NIHR Signal, go to: https://discover.dc.nihr.ac.uk/content/signal-000841/weight-loss-after-type-2-diabetes-diagnosis-boosts-chance-of-remission.
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Diabetes Mellitus Tipo 2 , Pérdida de Peso , Peso Corporal , Humanos , Estudios Prospectivos , Medicina EstatalRESUMEN
Treatment adherence in adults with cystic fibrosis (CF) is poor. One of the reasons identified for lack of adherence to nebulised treatments is that patients may not experience any immediate relief in their symptoms or notice changes as a result of taking their treatment, thus many report that they do not perceive there to be consequences of non adherence. The aim of the study was to investigate the temporal relationships between symptoms and adherence to nebulised treatments in adults with CF using an N-of-1 observational design. Six participants were recruited for a six-week period during which time they completed a daily online respiratory symptom questionnaire. Adherence to treatment was measured throughout the duration of the study using an eTrack® nebuliser that logged date and time of treatments taken. Data generated from each participant was analysed separately. There were significant relationships between pain and adherence for three participants, tiredness and adherence for one participant and cough and adherence for one participant. For all of these findings, the symptom and adherence were experienced on the same day. Extending the monitoring period beyond six weeks may provide increased insight into the complex relationship between symptoms and adherence in CF.
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BACKGROUND: Inaccessible services and poor communication are barriers to successful transitions between adolescent and adult mental health services, for which digital communications (DC) offer a possible solution. AIMS: To investigate the role of DC, including smartphone apps, email and text, given the known barriers and facilitators of mental health service transitions reported in the literature. METHODS: Use of Neale's (2016) iterative categorisation technique to undertake a secondary analysis of qualitative data collected for the Long-term conditions Young people Networked Communication (LYNC) study. RESULTS: DC were used successfully by young people and staff in ways that ameliorated known barriers to service transitions. They engendered responsibility in young people, promoted service access and contributed to client safety, particularly in times of crisis. DC risks included over-familiarity between young people and staff, and the possibility that messages could go unread. CONCLUSIONS: DC have the potential to facilitate trust and familiarity during and after transition to adult mental health services. They can strengthen young people's perceptions of adult services as supportive, empowering and available. DC can be used for frequent 'check-ins' and remote digital support for social and personal problems. They provide an additional safety net for at-risk individuals, but require careful boundary setting.
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The studyEveritt H, Landau G, Little P. Therapist telephone-delivered CBT and web-based CBT compared with treatment as usual in refractory irritable bowel syndrome: the ACTIB three-arm RCT. Health Technol Assess 2019;23:1-154.This project was funded by the NIHR Health Technology Assessment Programme (project number 11/69/02).To read the full NIHR Signal, go to https://discover.dc.nihr.ac.uk/content/signal-000784/irritable-bowel-syndrome-helped-by-telephone-or-internet-cbt.
Asunto(s)
Síndrome del Colon Irritable , Humanos , Internet , Logopedia , Evaluación de la Tecnología Biomédica , TeléfonoRESUMEN
The studyGilbert R, Brown M, Rainford N et al. Antimicrobial-impregnated central venous catheters for prevention of neonatal bloodstream infection (PREVAIL): an open-label, parallel-group, pragmatic, randomised controlled trial. Lancet Child Adolesc Health 2019;3:381-90.The study was funded by the NIHR Health Technology Assessment programme (project number 12/167/02).To read the full NIHR Signal, go to https://discover.dc.nihr.ac.uk/content/signal-000782/antimicrobial-central-venous-catheters-for-pre-term-babies-do-not-reduce-infections.
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Antiinfecciosos , Bacteriemia , Catéteres Venosos Centrales , Antibacterianos , Niño , Humanos , Lactante , Recién Nacido , Evaluación de la Tecnología BiomédicaRESUMEN
The studyLyttle MD, Rainford NEA, Gamble C, et al. Levetiracetam versus phenytoin for second-line treatment of paediatric convulsive status epilepticus (EcLiPSE): a multicentre, open-label, randomised trial. Lancet 2019;393:2125-34.This trial was funded by the NIHR Health Technology Assessment Programme (project number 12/127/134).To read the full NIHR Signal, go to https://discover.dc.nihr.ac.uk/content/signal-000790/levetiracetam-vs-phenytoin-in-stopping-childrens-prolonged-epileptic-seizures.
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Epilepsia , Estado Epiléptico , Niño , Humanos , Levetiracetam , Fenitoína , ConvulsionesRESUMEN
The studyTaylor RS, Walker S, Ciani O, et al. Exercise-based cardiac rehabilitation for chronic heart failure: the EXTRAMATCH II individual participant data meta-analysis. Health Technol Assess 2019;23:1-98.This project was funded by the NIHR Health Technology Assessment Programme (project number 15/80/30).To read the full NIHR Signal, go to https://discover.dc.nihr.ac.uk/content/signal-000803/cardiac-rehabilitation-for-heart-failure-can-improve-quality-of-life-and-fitness.
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Rehabilitación Cardiaca , Insuficiencia Cardíaca , Ejercicio Físico , Terapia por Ejercicio , Humanos , Calidad de VidaRESUMEN
The studyPeden CJ, Stephens T, Martin G et al. Effectiveness of a national quality improvement programme to improve survival after emergency abdominal surgery (EPOCH): a stepped-wedge cluster-randomised trial. Lancet 2019;393:2213-21.This project was funded by the NIHR Health Services and Delivery Research Programme (project number 12/5005/10).To read the full NIHR Signal, go to https://discover.dc.nihr.ac.uk/content/signal-000789/national-quality-improvement-programmes-need-time-and-resources-to-have-impact.
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Dolor Abdominal/cirugía , Procedimientos Quirúrgicos del Sistema Digestivo , Tratamiento de Urgencia , Mejoramiento de la Calidad/organización & administración , Enfermedad Aguda , Análisis por Conglomerados , Vías Clínicas , Procedimientos Quirúrgicos del Sistema Digestivo/normas , Tratamiento de Urgencia/normas , Humanos , Evaluación de Programas y Proyectos de Salud , Mejoramiento de la Calidad/normasRESUMEN
The studyTaylor S, Mallett S, Beare S et al. Diagnostic accuracy of whole-body MRI versus standard imaging pathways for metastatic disease in newly diagnosed colorectal cancer: the prospective Streamline C trial. Lancet Gastroenterol Hepatol 2019;4:529-37.This project was funded by the NIHR Health Technology Assessment Programme (project number 10/68/01).To read the full NIHR Signal, go to https://discover.dc.nihr.ac.uk/content/signal-000797/identifying-metastatic-disease-in-colorectal-cancer-with-whole-body-mri.
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Neoplasias Colorrectales , Neoplasias Primarias Secundarias , Humanos , Imagen por Resonancia Magnética , Estudios Prospectivos , Evaluación de la Tecnología BiomédicaRESUMEN
The studyStory A, Aldridge R, Smith C, et al. Smartphone-enabled video-observed versus directly observed treatment for tuberculosis: a multicentre, analyst-blinded, randomised, controlled superiority trial. Lancet 2019;393:1216-24.The study was funded by the NIHR Programme Grants for Applied Research programme (project number RP-PG-0407-10340).To read the full NIHR Signal, go to https://discover.dc.nihr.ac.uk/content/signal-000777/smartphones-for-tb-treatment-observation.
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Teléfono Inteligente , Tuberculosis , HumanosRESUMEN
The studyFeatherstone K, Northcott A, Harden J, et al. Refusal and resistance to care by people living with dementia being cared for within acute hospital wards: an ethnographic study. Health Serv Deliv Res 2019;7.This study was funded by the National Institute for Health Research Health Services and Delivery Research Programme (project number 13/10/80).To read the full NIHR Signal, go to https://discover.dc.nihr.ac.uk/content/signal-000779/understanding-dementia-care-in-hospitals.
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Demencia/enfermería , Demencia/psicología , Hospitalización , Cooperación del Paciente , Inglaterra , Humanos , Relaciones Profesional-Paciente , Medicina Estatal/normas , GalesRESUMEN
The studyA Rodger, V Cambiano, T Bruun, et al. Risk of HIV transmission through condomless sex in serodifferent gay couples with the HIV-positive partner taking suppressive antiretroviral therapy (PARTNER): final results of a multicentre, prospective, observational study. Lancet 2019;393:2428-38.This project was funded by the NIHR Research for Patient Benefit Programme (project number PB-PG-1013-32069).To read the full NIHR Signal, go to https://discover.dc.nihr.ac.uk/content/signal-000785/antiretroviral-treatment-can-reduce-the-risk-of-hiv-transmission-between-male-partners-to-zero.
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Infecciones por VIH , Minorías Sexuales y de Género , VIH , Humanos , Masculino , Estudios Prospectivos , Parejas SexualesRESUMEN
The studyGazzard G, Konstantakopoulou G, Garway-Heath E, et al. Selective laser trabeculoplasty versus eye drops for first-line treatment of ocular hypertension and glaucoma (LiGHT): a multicentre randomised controlled trial. Lancet 2019; doi:10.1016/S0140-6736(18)32213-XThis project was funded by the NIHR Health Technology Assessment Programme (project number 09/104/40) and was sponsored by the Moorfields Eye Hospital NHS Foundation Trust.To read the full NIHR Signal, go to https://discover.dc.nihr.ac.uk/content/signal-000774/early-glaucoma-laser-eye-treatment-trabeculoplasty.