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1.
Int J Obes (Lond) ; 2024 Jun 26.
Artículo en Inglés | MEDLINE | ID: mdl-38918554

RESUMEN

BACKGROUND: Limited evidence from the United States suggests that county/state rates of people with obesity are positively associated with voting for the Republican Party presidential candidate, although this question has not yet been studied at the individual level, and/or outside of the United States, where the health and political systems are very different in other countries. OBJECTIVES: Using individual level data, assess differences in rates of people with obesity according to political voting in the United Kingdom 2019 general election, and examine whether people living in constituencies won by Members of Parliament (MPs) from the Conservative Party were more likely to be living with obesity than those living in constituencies won by MPs from other parties. METHODS: Data was obtained by the Ipsos KnowledgePanel where panellists are recruited via a random probability unclustered address-based sampling method. 4000/14,016 panellists were randomly invited to provide data on socio-demographics, health outcomes, voting behaviour and height/weight. RESULTS: 2668/4000 (67%) of invitees provided data, 95/2668 (3.5%) were not eligible to vote, with the remaining 2573 (96.5%) included. Conservative Party voters were more likely to be living with obesity than those who voted Labour (OR:1.42 95% CI (1.01-1.99)) or Liberal Democrats (1.54 95% CI (1.00-2.37)). Conservative Party voters on average had significantly higher BMI scores than those voting Labour and Liberal Democrats; BMI mean difference 0.88 points (95% CI: 0.16-1.61) between Conservative and Labour voters, and 1.04 points (95% CI: 0.07-2.02) between Conservatives and Liberal Democrats voters. There was no evidence participants living in constituencies won by Conservative MPs were more likely to be living with obesity than constituencies won by other party MPs. CONCLUSION: Governments and public health agencies may need to focus on the political affiliation of the public when developing strategies to reduce the number of people with obesity.

2.
Support Care Cancer ; 32(1): 87, 2024 Jan 08.
Artículo en Inglés | MEDLINE | ID: mdl-38185712

RESUMEN

OBJECTIVE: The benefits of physical activity across the cancer continuum for many adult cancers are well established. However, physical activity is yet to be routinely implemented into health services throughout the world. This study aims to explore patients' and healthcare professionals' views about integrating conversations and support for physical activity into routine care during treatment for breast cancer. METHODS: Healthcare professionals and patients from across the UK living with or beyond breast cancer were invited to take part in semi-structured interviews that were conducted online. Recruitment for the study was advertised on social media, in cancer support groups and newsletters. Data were analysed using inductive thematic analysis. RESULTS: Three themes captured perceptions of integrating support for physical activity in routine breast cancer care among 12 health care professionals (who deliver breast cancer care) and 15 patients. Themes between healthcare professionals and patients overlapped, and therefore, combined themes are presented. These were: (1) current practice; (2) implementation in care and (3) training needs. CONCLUSION: Many healthcare professionals who offer cancer care are reluctant to raise the topic of physical activity with patients, yet patients have suggested that they would like additional support to be physically active from their medical team. Providing healthcare professionals with education regarding the benefits of physical activity to reduce the risk of recurrence along with evidence based low-cost, remote interventions would allow them to integrate conversations about physical activity within routine cancer care for all patients.


Asunto(s)
Neoplasias de la Mama , Adulto , Humanos , Femenino , Neoplasias de la Mama/terapia , Miedo , Ejercicio Físico , Personal de Salud , Atención a la Salud
3.
Phys Rev Lett ; 128(6): 063601, 2022 Feb 11.
Artículo en Inglés | MEDLINE | ID: mdl-35213192

RESUMEN

Capturing non-Markovian dynamics of open quantum systems is generally a challenging problem, especially for strongly interacting many-body systems. In this Letter, we combine recently developed non-Markovian quantum state diffusion techniques with tensor network methods to address this challenge. As a first example, we explore a Hubbard-Holstein model with dissipative phonon modes, where this new approach allows us to quantitatively assess how correlations spread in the presence of non-Markovian dissipation in a 1D many-body system. We find regimes where correlation growth can be enhanced by these effects, offering new routes for dissipatively enhancing transport and correlation spreading, relevant for both solid state and cold atom experiments.

4.
BMC Public Health ; 22(1): 618, 2022 03 29.
Artículo en Inglés | MEDLINE | ID: mdl-35351075

RESUMEN

BACKGROUND: Many people do not meet the recommended health guidance of participation in a minimum of 150-300 min of moderate intensity physical activity per week, often promoted as at least 30 min of physical activity on 5 days of the week. This is concerning and highlights the importance of finding innovative ways to help people to be physically active each day. Snacktivity™ is a novel approach that aims to encourage people to do small, 2-5 min bouts of physical activity 'snacks' throughout the whole day, such that they achieve at least 150 min of moderate intensity activity per week. However, before it can be recommended, there is a need to explore whether the concept is acceptable to the public. METHODS: A survey to assess the views of the public about Snacktivity™ was distributed to adult patients registered at six general practices in the West Midlands, UK and to health care employees in the same region. RESULTS: A total of 5989 surveys were sent to patients, of which 558 were returned (9.3%). A further 166 surveys were completed by health care employees. A total of 85% of respondents liked the Snacktivity™ concept. The flexibility of the approach was highly rated. A high proportion of participants (61%) reported that the ability to self-monitor their behaviour would help them to do Snacktivity™ throughout their day. Physically inactive participants perceived that Snacktivity™ would help to increase their physical activity, more than those who were physically active (OR = 0.41, 95% CI: 0.25-0.67). Approximately 90% of respondents perceived that Snacktivity™ was easy to do on a non-working day compared to 60% on a working day. Aerobic activity 'snacks' were preferred to those which were strength based. CONCLUSIONS: The Snacktivity™ approach to promoting physical activity was viewed positively by the public and interventions to test the merits of such an approach now need to be developed and tested in a variety of everyday contexts.


Asunto(s)
Ejercicio Físico , Conducta Sedentaria , Adulto , Humanos , Encuestas y Cuestionarios
5.
Biol Lett ; 17(6): 20210226, 2021 06.
Artículo en Inglés | MEDLINE | ID: mdl-34129798

RESUMEN

Peracarida (e.g. woodlice and side-swimmers) are, together with their sister-group Eucarida (e.g. krill and decapods), the most speciose group of modern crustaceans, suggested to have appeared as early as the Ordovician. While eucarids' incursion onto land consists of mainly freshwater and littoral grounds, some peracarids have evolved fully terrestrial ground-crawling ecologies, inhabiting even our gardens in temperate regions (e.g. pillbugs and sowbugs). Their fossil record extends back to the Carboniferous and consists mainly of marine occurrences. Here, we provide a complete re-analysis of a fossil arthropod-Oxyuropoda-reported in 1908 from the Late Devonian floodplains of Ireland, and left with unresolved systematic affinities despite a century of attempts at identification. Known from a single specimen preserved in two dimensions, we analysed its anatomy using digital microscopy and multispectral macroimaging to enhance the contrast of morphological structures. The new anatomical characters and completeness of Oxyuropoda, together with a phylogenetic analysis with representatives of all major Eumalacostraca groups, indicate that Oxyuropoda is a crown peracarid, part of a clade including amphipods and isopods. As such, Oxyuropoda is the oldest known species Peracarida, and provides evidence that derived peracarids had an incursion into freshwater and terrestrial environments as early as the Famennian, more than 360 Ma.


Asunto(s)
Isópodos , Animales , Fósiles , Agua Dulce , Irlanda , Filogenia
6.
Phys Rev Lett ; 125(18): 180402, 2020 Oct 30.
Artículo en Inglés | MEDLINE | ID: mdl-33196275

RESUMEN

We explore the relationship between symmetrization and entanglement through measurements on few-particle systems in a multiwell potential. In particular, considering two or three trapped atoms, we measure and distinguish correlations arising from two different physical origins: antisymmetrization of the fermionic wave function and interaction between particles. We quantify this through the entanglement negativity of states, and the introduction of an antisymmetric negativity, which allows us to understand the role that symmetrization plays in the measured entanglement properties. We apply this concept both to pure theoretical states and to experimentally reconstructed density matrices of two or three mobile particles in an array of optical tweezers.

7.
BMC Med ; 17(1): 51, 2019 03 01.
Artículo en Inglés | MEDLINE | ID: mdl-30819170

RESUMEN

BACKGROUND: Guidelines recommend that clinicians should make brief opportunistic behavioural interventions to patients who are obese to increase the uptake of effective weight loss programmes. The objective was to assess the effect of this policy on socioeconomic equity. METHODS: One thousand eight hundred eighty-two consecutively attending patients with obesity and who were not seeking support for weight loss from their GP were enrolled in a trial. Towards the end of each consultation, GPs randomly assigned participants to one of two 30-s interventions. In the active intervention (support arm), the GP offered referral to a weight management group. In the control intervention (advice arm), the GP advised the patient that their health would benefit from weight loss. Agreement to attend a behavioural weight loss programme, attendance at the programme and weight loss at 12 months were analysed by socioeconomic status, measured by postcode using the Index of Multiple Deprivation (IMD). RESULTS: Mean weight loss was 2.43 kg (sd 6.49) in the support group and 1.04 kg (sd 5.50) for the advice only group, but these effects were moderated by IMD (p = 0.039 for the interaction). In the support arm, weight loss was greater in higher socioeconomic groups. Participants from lower socioeconomic backgrounds were more likely to accept the offer and equally likely to attend a weight loss referral but attended fewer sessions. Adjusting for these sequentially reduced the gradient for the association of socioeconomic status with weight loss from + 0.035 to - 0.001 kg/IMD point. In the advice only arm, 10% took effective action to promote weight loss. The decision to seek support for weight loss outside of the trial did not differ by socioeconomic status, but weight loss among deprived participants who used external support was greater than among more affluent participants (p = 0.025). CONCLUSION: Participants' responses to GPs' brief opportunistic interventions to promote weight loss differed by socioeconomic status and trial arm. In the support arm, more deprived people lost less weight because they attended fewer sessions at the programme. In the advice arm, more deprived people who sought and paid for support for weight loss themselves lost more weight than more affluent people who sought support. TRIAL REGISTRATION: This trial is registered with the ISRCTN registry, number ISRCTN26563137 . Date of registration: January 3, 2013; date of first participant recruited: June 4, 2014.


Asunto(s)
Obesidad/terapia , Atención Primaria de Salud/economía , Pérdida de Peso/fisiología , Programas de Reducción de Peso/métodos , Análisis Costo-Beneficio , Femenino , Humanos , Masculino , Persona de Mediana Edad
8.
Phys Rev Lett ; 120(6): 060401, 2018 Feb 09.
Artículo en Inglés | MEDLINE | ID: mdl-29481272

RESUMEN

We show how experimentally available bilayer lattice systems can be used to prepare quantum many-body states with exceptionally low entropy in one layer, by dynamically disentangling the two layers. This disentangling operation moves one layer-subsystem A-into a regime where excitations in A develop a single-particle gap. As a result, this operation maps directly to cooling for subsystem A, with entropy being shuttled to the other layer. For both bosonic and fermionic atoms, we study the corresponding dynamics showing that disentangling can be realized cleanly in ongoing experiments. The corresponding entanglement entropies are directly measurable with quantum gas microscopes, and, as a tool for producing lower-entropy states, this technique opens a range of applications beginning with simplifying production of magnetically ordered states of bosons and fermions.

9.
Diabet Med ; 34(11): 1521-1531, 2017 11.
Artículo en Inglés | MEDLINE | ID: mdl-28905421

RESUMEN

AIM: Residual ß-cell function is present at the time of diagnosis with Type 1 diabetes. Preserving this ß-cell function reduces complications. We hypothesized that exercise preserves ß-cell function in Type 1 diabetes and undertook a pilot trial to address the key uncertainties in designing a definitive trial to test this hypothesis. METHODS: A randomized controlled pilot trial in adults aged 16-60 years diagnosed with Type 1 diabetes within the previous 3 months was undertaken. Participants were assigned to control (usual care) or intervention (exercise consultation every month), in a 1 : 1 ratio for 12 months. The primary outcomes were recruitment rate, drop out, exercise adherence [weeks with ≥ 150 min of self-reported moderate to vigorous physical activity (MVPA)], and exercise uptake in the control group. The secondary outcomes were differences in insulin sensitivity and rate of loss of ß-cell function between intervention and control at 6 and 12 months. RESULTS: Of 507 individuals who were approached, 58 (28 control, 30 intervention) entered the study and 41 completed it. Participants were largely white European males, BMI 24.8 ± 3.8 kg/m2 , HbA1c 75 ± 25 mmol/mol (9 ± 2%). Mean level of objectively measured MVPA increased in the intervention group (mean 243 to 273 min/week) and 61% of intervention participants reached the target of ≥ 150 min/week of self-reported MVPA on at least 42 weeks of the year. Physical activity levels fell slightly in the control group (mean 277 to 235 min of MVPA/week). There was exploratory evidence that intervention group became more insulin sensitive and required less insulin. However, the rate of loss of ß-cell function appeared similar between the groups, although the change in insulin sensitivity may have affected this. CONCLUSION: We show that it is possible to recruit and randomize people with newly diagnosed Type 1 diabetes to a trial of an exercise intervention, and increase and maintain their exercise levels for 12 months. Future trials need to incorporate measures of greater adherence to exercise training targets, and include more appropriate measures of ß-cell function. (Clinical Trials Registry No; ISRCTN91388505).


Asunto(s)
Diabetes Mellitus Tipo 1/fisiopatología , Diabetes Mellitus Tipo 1/terapia , Ejercicio Físico/fisiología , Células Secretoras de Insulina/fisiología , Adolescente , Adulto , Edad de Inicio , Diabetes Mellitus Tipo 1/metabolismo , Terapia por Ejercicio , Femenino , Humanos , Masculino , Persona de Mediana Edad , Proyectos Piloto , Adulto Joven
10.
Phys Rev Lett ; 116(20): 205301, 2016 May 20.
Artículo en Inglés | MEDLINE | ID: mdl-27258874

RESUMEN

We report on the experimental implementation of tunable occupation-dependent tunneling in a Bose-Hubbard system of ultracold atoms via time-periodic modulation of the on-site interaction energy. The tunneling rate is inferred from a time-resolved measurement of the lattice site occupation after a quantum quench. We demonstrate coherent control of the tunneling dynamics in the correlated many-body system, including full suppression of tunneling as predicted within the framework of Floquet theory. We find that the tunneling rate explicitly depends on the atom number difference in neighboring lattice sites. Our results may open up ways to realize artificial gauge fields that feature density dependence with ultracold atoms.

11.
Int J Behav Nutr Phys Act ; 13: 12, 2016 Feb 01.
Artículo en Inglés | MEDLINE | ID: mdl-26830026

RESUMEN

It has been argued that transition points in life, such as the approach towards, and early years of retirement present key opportunities for interventions to improve the health of the population. Research has also highlighted inequalities in health status in the retired population and in response to interventions which should be addressed. We aimed to conduct a systematic review to synthesise international evidence on the types and effectiveness of interventions to increase physical activity among people around the time of retirement. A systematic review of literature was carried out between February 2014 and April 2015. Searches were not limited by language or location, but were restricted by date to studies published from 1990 onwards. Methods for identification of relevant studies included electronic database searching, reference list checking, and citation searching. Systematic search of the literature identified 104 papers which described study populations as being older adults. However, we found only one paper which specifically referred to their participants as being around the time of retirement. The intervention approaches for older adults encompassed: training of health care professionals; counselling and advice giving; group sessions; individual training sessions; in-home exercise programmes; in-home computer-delivered programmes; in-home telephone support; in-home diet and exercise programmes; and community-wide initiatives. The majority of papers reported some intervention effect, with evidence of positive outcomes for all types of programmes. A wide range of different measures were used to evaluate effectiveness, many were self-reported and few studies included evaluation of sedentary time. While the retirement transition is considered a significant point of life change, little research has been conducted to assess whether physical activity interventions at this time may be effective in promoting or maintaining activity, or reducing health inequalities. We were unable to find any evidence that the transition to retirement period was, or was not a significant point for intervention. Studies in older adults more generally indicated that a range of interventions might be effective for people around retirement age.


Asunto(s)
Empleo , Ejercicio Físico , Promoción de la Salud , Jubilación , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Actividad Motora
12.
Int J Obes (Lond) ; 39(11): 1601-6, 2015 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-26095246

RESUMEN

BACKGROUND/OBJECTIVES: Maintaining a healthy weight is important for the prevention of many chronic diseases. Little is known about the strategies used by young women to manage their weight, or the effectiveness of these in preventing weight gain. We aimed to identify clusters of weight control strategies used by women and to determine the average annual weight change among women in each cluster from 2000 to 2009. METHODS: Latent cluster analysis of weight control strategies reported by 8125 participants in the Australian Longitudinal Study of Women's Health. Analyses were performed in March-November 2014. RESULTS: Weight control strategies were used by 79% of the women, and four unique clusters were found. The largest cluster group (39.7%) was named dieters as 90% had been on a diet in the past year, and half of these women had lost 5 kg on purpose. Women cut down on size of meals, fats and sugars and took part in vigorous physical activity. Additionally 20% had used a commercial programme. The next largest cluster (30.2%) was the healthy living group who followed the public health messages of 'eat less and move more'. The do nothing group (20%) did not actively control their weight whereas the perpetual dieters group (10.7%) used all strategies, including unhealthy behaviours. On average women gained 700 g per year (over 9 years); however, the perpetual dieters group gained significantly more weight (210 g) than the do nothing group (P<0.001). CONCLUSIONS: Most women are actively trying to control their weight. The most successful approach was to follow the public health guidelines on health eating and physical activity.


Asunto(s)
Dieta , Ejercicio Físico , Conductas Relacionadas con la Salud , Obesidad/psicología , Australia/epidemiología , Análisis por Conglomerados , Ingestión de Energía , Metabolismo Energético , Femenino , Conocimientos, Actitudes y Práctica en Salud , Humanos , Estudios Longitudinales , Obesidad/prevención & control , Cooperación del Paciente , Salud Pública , Aumento de Peso , Salud de la Mujer , Adulto Joven
13.
Psychol Med ; 45(11): 2413-25, 2015 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-25804297

RESUMEN

BACKGROUND: Postnatal depression affects about 10-15% of women in the year after giving birth. Many women and healthcare professionals would like an effective and accessible non-pharmacological treatment for postnatal depression. METHOD: Women who fulfilled the International Classification of Diseases (ICD)-10 criteria for major depression in the first 6 months postnatally were randomized to receive usual care plus a facilitated exercise intervention or usual care only. The intervention involved two face-to-face consultations and two telephone support calls with a physical activity facilitator over 6 months to support participants to engage in regular exercise. The primary outcome was symptoms of depression using the Edinburgh Postnatal Depression Scale (EPDS) at 6 months post-randomization. Secondary outcomes included EPDS score as a binary variable (recovered and improved) at 6 and 12 months post-randomization. RESULTS: A total of 146 women were potentially eligible and 94 were randomized. Of these, 34% reported thoughts of self-harming at baseline. After adjusting for baseline EPDS, analyses revealed a -2.04 mean difference in EPDS score, favouring the exercise group [95% confidence interval (CI) -4.11 to 0.03, p = 0.05]. When also adjusting for pre-specified demographic variables the effect was larger and statistically significant (mean difference = -2.26, 95% CI -4.36 to -0.16, p = 0.03). Based on EPDS score a larger proportion of the intervention group was recovered (46.5% v. 23.8%, p = 0.03) compared with usual care at 6 months follow-up. CONCLUSIONS: This trial shows that an exercise intervention that involved encouragement to exercise and to seek out social support to exercise may be an effective treatment for women with postnatal depression, including those with thoughts of self-harming.


Asunto(s)
Depresión Posparto/terapia , Depresión/terapia , Trastorno Depresivo Mayor/terapia , Terapia por Ejercicio/métodos , Adulto , Femenino , Humanos , Escalas de Valoración Psiquiátrica , Conducta Autodestructiva , Apoyo Social , Encuestas y Cuestionarios , Resultado del Tratamiento , Adulto Joven
14.
BJOG ; 122(1): 57-62, 2015 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-24935560

RESUMEN

BACKGROUND: Antenatal depression can have harmful consequences for the mother and fetus. Exercise may be a useful intervention to prevent and treat antenatal depression. OBJECTIVES: This systematic review aims to establish whether there is sufficient evidence to conclude that exercise is an effective intervention for preventing and treating antenatal depression. SEARCH STRATEGY: Searches using electronic databases from MEDLINE, Cochrane Library, CINAHL, EMBASE, AMED and PsycINFO were performed. SELECTION CRITERIA: Randomised controlled trials (RCT) that compared any type of exercise intervention with any comparator in pregnant women were eligible for inclusion. DATA COLLECTION AND ANALYSIS: Meta-analysis was performed calculating standardised mean differences (SMD). MAIN RESULTS: Six trials (seven comparisons) were eligible for inclusion. Meta-analysis showed a significant reduction in depression scores (SMD -0.46, 95% CI -0.87 to -0.05, P = 0.03, I(2) = 68%) for exercise interventions relative to comparator groups. The test for subgroup differences in women who were non-depressed (one trial) (SMD -0.74, 95%CI -1.22 to -0.27, P = 0.002) and depressed (five trials) (SMD -0.41, 95% CI -0.88 to 0.07, P = 0.09) at baseline was not significant (P = 0.32). The test for subgroup differences between aerobic (one trial) and non-aerobic exercise (five trials) was also nonsignificant (P = 0.32). AUTHORS' CONCLUSIONS: We found some evidence that exercise may be effective in treating depression during pregnancy but this conclusion is based on a small number of low-moderate quality trials with significant heterogeneity and wide confidence intervals.


Asunto(s)
Depresión/prevención & control , Trastorno Depresivo/prevención & control , Terapia por Ejercicio/métodos , Complicaciones del Embarazo/prevención & control , Depresión/terapia , Trastorno Depresivo/terapia , Femenino , Humanos , Embarazo , Complicaciones del Embarazo/terapia , Resultado del Tratamiento
15.
BJOG ; 122(4): 565-75, 2015 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-25516405

RESUMEN

OBJECTIVE: To investigate the effectiveness of exercise as treatment for vasomotor menopausal symptoms. DESIGN: Three-group randomised controlled trial, two exercise interventions and a control group. SETTING: Primary Care, West Midlands UK. POPULATION: Perimenopausal and postmenopausal women experiencing at least five hot flushes/night sweats per day and not taken MHT in previous 3 months were recruited from 23 general practices. METHODS: Participants in both exercise interventions groups were offered two face-to-face consultations with a physical activity facilitator to support engagement in regular exercise. In addition, one exercise group received a menopause-specific information DVD and written materials to encourage regular exercise and the other exercise group was offered the opportunity to attend exercise social support groups in their communities. Interventions lasted 6 months. MAIN OUTCOME MEASURE: The primary outcome was frequency of hot flushes/night sweats at 6-month up. RESULTS: Two hundred and sixty-one women were randomised (n = 87 per group). Neither of the exercise intervention groups reported significantly less frequent hot flushes/night sweats per week than controls (exercise-DVD versus control: -8.9, 95% CI -20.0 to 2.2; exercise-social support versus control: -5.2, 95% CI -16.7 to 6.3). CONCLUSIONS: This trial indicates that exercise is not an effective treatment for hot flushes/night sweats. Contrary to current clinical guidance, women should not be advised that exercise will relieve their vasomotor menopausal symptoms.


Asunto(s)
Ejercicio Físico , Sofocos/prevención & control , Menopausia , Femenino , Estudios de Seguimiento , Humanos , Menopausia/metabolismo , Persona de Mediana Edad , Estudios Observacionales como Asunto , Atención Primaria de Salud , Sudoración , Resultado del Tratamiento , Reino Unido
16.
Mult Scler ; 20(8): 1123-30, 2014 07.
Artículo en Inglés | MEDLINE | ID: mdl-24421304

RESUMEN

BACKGROUND: Exercise is a safe, non-pharmacological adjunctive treatment for people with multiple sclerosis but cost-effective approaches to implementing exercise within health care settings are needed. OBJECTIVE: The objective of this paper is to assess the cost effectiveness of a pragmatic exercise intervention in conjunction with usual care compared to usual care only in people with mild to moderate multiple sclerosis. METHODS: A cost-utility analysis of a pragmatic randomised controlled trial over nine months of follow-up was conducted. A total of 120 people with multiple sclerosis were randomised (1:1) to the intervention or usual care. Exercising participants received 18 supervised and 18 home exercise sessions over 12 weeks. The primary outcome for the cost utility analysis was the incremental cost per quality-adjusted life year (QALY) gained, calculated using utilities measured by the EQ-5D questionnaire. RESULTS: The incremental cost per QALY of the intervention was £10,137 per QALY gained compared to usual care. The probability of being cost effective at a £20,000 per QALY threshold was 0.75, rising to 0.78 at a £30,000 per QALY threshold. CONCLUSION: The pragmatic exercise intervention is highly likely to be cost effective at current established thresholds, and there is scope for it to be tailored to particular sub-groups of patients or services to reduce its cost impact.


Asunto(s)
Terapia por Ejercicio/economía , Costos de la Atención en Salud , Esclerosis Múltiple Crónica Progresiva/economía , Esclerosis Múltiple Crónica Progresiva/terapia , Esclerosis Múltiple Recurrente-Remitente/economía , Esclerosis Múltiple Recurrente-Remitente/terapia , Adulto , Análisis Costo-Beneficio , Inglaterra , Femenino , Humanos , Masculino , Persona de Mediana Edad , Modelos Económicos , Esclerosis Múltiple Crónica Progresiva/diagnóstico , Esclerosis Múltiple Crónica Progresiva/fisiopatología , Esclerosis Múltiple Recurrente-Remitente/diagnóstico , Esclerosis Múltiple Recurrente-Remitente/fisiopatología , Años de Vida Ajustados por Calidad de Vida , Índice de Severidad de la Enfermedad , Encuestas y Cuestionarios , Factores de Tiempo , Resultado del Tratamiento
17.
Mult Scler ; 20(8): 1112-22, 2014 07.
Artículo en Inglés | MEDLINE | ID: mdl-24421303

RESUMEN

BACKGROUND: Exercise programmes that can demonstrate evidence of long-lasting clinical effectiveness are needed for people with multiple sclerosis (PwMS). OBJECTIVE: The objective of this study was to assess the effects of a practically implemented exercise programme on self-directed exercise behaviour and important health outcomes in PwMS to nine months of follow-up. METHODS: We conducted a parallel-arm, randomised controlled trial: 120 PwMS (Expanded Disability Status Scale (EDSS) 1.0-6.5) randomised to a three-month exercise intervention plus usual care, or usual care only. Two supervised plus one home-exercise session (weeks 1-6) were followed by one supervised and two home-exercise sessions (weeks 7-12). Cognitive-behavioural techniques promoted long-term exercise behaviour change. Outcomes were blindly assessed at baseline and at three and nine months after randomisation. The primary outcome was self-reported exercise behaviour (Godin Leisure Time Exercise Questionnaire (GLTEQ)). Secondary outcomes included fatigue and health-related quality of life (HRQoL). RESULTS: The intervention increased self-reported exercise (9.6 points; 95% CI: 2.0 to 17.3 points; p = 0.01) and improved fatigue (p < 0.0001) and many HRQoL domains (p ≤ 0.03) at three months. The improvements in emotional well-being (p = 0.01), social function (p = 0.004) and overall quality of life (p = 0.001) were sustained for nine months. CONCLUSION: This pragmatic approach to implementing exercise increases self-reported exercise behaviour, improves fatigue and leads to a sustained enhancement of HRQoL domains in PwMS.


Asunto(s)
Terapia Cognitivo-Conductual/métodos , Terapia por Ejercicio/métodos , Conductas Relacionadas con la Salud , Esclerosis Múltiple Crónica Progresiva/terapia , Esclerosis Múltiple Recurrente-Remitente/terapia , Autocuidado/métodos , Adulto , Evaluación de la Discapacidad , Emociones , Inglaterra , Femenino , Conocimientos, Actitudes y Práctica en Salud , Estado de Salud , Humanos , Masculino , Salud Mental , Persona de Mediana Edad , Esclerosis Múltiple Crónica Progresiva/diagnóstico , Esclerosis Múltiple Crónica Progresiva/fisiopatología , Esclerosis Múltiple Crónica Progresiva/psicología , Esclerosis Múltiple Recurrente-Remitente/diagnóstico , Esclerosis Múltiple Recurrente-Remitente/fisiopatología , Esclerosis Múltiple Recurrente-Remitente/psicología , Calidad de Vida , Conducta Social , Encuestas y Cuestionarios , Factores de Tiempo , Resultado del Tratamiento
18.
Cancer Causes Control ; 24(1): 181-91, 2013 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-23184120

RESUMEN

Excess body weight at diagnosis and weight gain after breast cancer are associated with poorer long-term prognosis. This study investigated the effects of a lifestyle intervention on body weight and other health outcomes influencing long-term prognosis in overweight women (BMI > 25.0 kg/m(2)) recovering from early-stage (stage I-III) breast cancer. A total of 90 women treated 3-18 months previously were randomly allocated to a 6-month exercise and hypocaloric healthy eating program (n = 47, aged 55.6 ± 10.2 year) or control group (n = 43, aged 55.9 ± 8.9 year). Women in the intervention group received three supervised exercise sessions per week and individualized dietary advice, supplemented by weekly nutrition seminars. Body weight, waist circumference, waist/hip ratio [WHR], cardiorespiratory fitness, blood biomarkers associated with breast cancer recurrence and cardiovascular disease risk, and quality of life (FACT-B) were assessed at baseline and 6 months. Three-day diet diaries were used to assess macronutrient and energy intakes. A moderate reduction in body weight in the intervention group (median difference from baseline of -1.09 kg; IQR -0.15 to -2.90 kg; p = 0.07) was accompanied by significant reductions in waist circumference (p < 0.001), WHR (p = 0.005), total (p = 0.021) and saturated fat (p = 0.006) intakes, leptin (p = 0.005), total cholesterol (p = 0.046), and resting diastolic blood pressure (p = 0.03). Cardiopulmonary fitness (p < 0.001) and FACT-B quality of life (p = 0.004) also showed significant improvements in the intervention group. These findings suggest that an individualized exercise and a hypocaloric healthy eating program can positively impact upon health outcomes influencing long-term prognosis in overweight women recovering from early-stage breast cancer.


Asunto(s)
Biomarcadores de Tumor , Neoplasias de la Mama/diagnóstico , Restricción Calórica , Carcinoma/diagnóstico , Ejercicio Físico/fisiología , Conducta Alimentaria/fisiología , Programas de Reducción de Peso/métodos , Adulto , Anciano , Biomarcadores de Tumor/análisis , Biomarcadores de Tumor/sangre , Biomarcadores de Tumor/metabolismo , Neoplasias de la Mama/complicaciones , Neoplasias de la Mama/patología , Neoplasias de la Mama/terapia , Carcinoma/complicaciones , Carcinoma/patología , Carcinoma/terapia , Terapia por Ejercicio/métodos , Femenino , Salud , Humanos , Persona de Mediana Edad , Estadificación de Neoplasias , Sobrepeso/sangre , Sobrepeso/complicaciones , Sobrepeso/diagnóstico , Sobrepeso/terapia , Pronóstico , Sobrevivientes/estadística & datos numéricos
19.
Phys Rev Lett ; 111(5): 053003, 2013 Aug 02.
Artículo en Inglés | MEDLINE | ID: mdl-23952393

RESUMEN

We study nonequilibrium dynamics for an ensemble of tilted one-dimensional atomic Bose-Hubbard chains after a sudden quench to the vicinity of the transition point of the Ising paramagnetic to antiferromagnetic quantum phase transition. The quench results in coherent oscillations for the orientation of effective Ising spins, detected via oscillations in the number of doubly occupied lattice sites. We characterize the quench by varying the system parameters. We report significant modification of the tunneling rate induced by interactions and show clear evidence for collective effects in the oscillatory response.

20.
Phys Rev Lett ; 109(2): 020505, 2012 Jul 13.
Artículo en Inglés | MEDLINE | ID: mdl-23030143

RESUMEN

We discuss a scheme to measure the many-body entanglement growth during quench dynamics with bosonic atoms in optical lattices. By making use of a 1D or 2D setup in which two copies of the same state are prepared, we show how arbitrary order Rényi entropies can be extracted by using tunnel coupling between the copies and measurement of the parity of on-site occupation numbers, as has been performed in recent experiments. We illustrate these ideas for a superfluid-Mott insulator quench in the Bose-Hubbard model, and also for hard-core bosons, and show that the scheme is robust against imperfections in the measurements.

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