Comparative effect of two educational videos on self-efficacy and kinesiophobia in people with knee osteoarthritis: an online randomised controlled trial.

OBJECTIVE: To compare change in self-efficacy for managing knee osteoarthritis (OA) pain and kinesiophobia after watching an educational video based on an empowerment and participatory discourse with a video based on a disease and impairment discourse. DESIGN: Two-arm randomised controlled trial with participants aged ≥45 years with knee pain (n = 589). Participants completed both baseline and follow-up outcomes and watched one randomly-allocated video (12-minute duration) during one 30-45-minute session within a single online survey. The experimental video presented evidence-based knee OA information using design and language that aimed to empower people and focus on activity participation to manage OA, while the control video presented similar information but with a disease and impairment focus. Primary outcome measures were Arthritis Self-Efficacy Scale pain subscale (range 0-10) and Brief Fear of Movement Scale for OA (range 6-24). Secondary outcomes were expectations about prognosis and physical activity benefits, perceived importance and motivation to be physically active, knee OA knowledge, hopefulness for the future, level of concern and perceived need for surgery. RESULTS: Compared to control (n = 293), the experimental group (n = 296) showed improved self-efficacy for managing OA pain (mean difference 0.4 [95%CI 0.2, 0.6] units) and reduced kinesiophobia (1.6 [1.1, 2.0] units). The experimental group also demonstrated greater improvements in all secondary outcomes apart from hopefulness, which was high in both groups. CONCLUSION: An educational video based on an empowerment and participatory discourse improved pain self-efficacy and reduced kinesiophobia in people with knee OA more than a video based on a disease and impairment discourse. CLINICALTRIALS: gov registration NCT05156216, Universal trial number U1111-1269-6143.

Correction to: Effectiveness of a new model of primary care management on knee pain and function in patients with knee osteoarthritis: Protocol for THE PARTNER STUDY.

After the publication of this protocol [1], our collaborator Prima Health solutions advised us of their intent to withdraw from the study.

A systematic review and evidence synthesis of qualitative studies to identify primary care clinicians' barriers and enablers to the management of osteoarthritis.

OBJECTIVE: Primary care management of osteoarthritis (OA) is variable and often inconsistent with clinical practice guidelines (CPGs). This study aimed to identify and synthesize available qualitative evidence on primary care clinicians' views on providing recommended management of OA. DESIGN: Eligibility criteria included full reports published in peer-reviewed journals, with data collected directly from primary care clinicians using qualitative methods for collection and analysis. Five electronic databases (MEDLINE, Cochrane Central Register, EMBASE, CINAHL and PsychInfo) were searched to August 2016. Two independent reviewers identified eligible reports, conducted critical appraisal (based on Critical Appraisal Skills Programme (CASP) criteria), and extracted data. Three reviewers independently, then collaboratively, synthesized and interpreted data through an inductive and iterative process to derive new themes. The Confidence in Evidence from Reviews of Qualitative research (CERQual) approach was used to determine a confidence profile for each finding. RESULTS: Eight studies involving approximately 83 general practitioners (GPs), 24 practice nurses, 12 pharmacists and 10 physical therapists, from Australia, France, United Kingdom, Germany and Mexico were included. Four barriers were identified as themes 1) OA is not that serious, 2) Clinicians are, or perceive they are, under-prepared, 3) Personal beliefs at odds with providing recommended practice, and 4) Dissonant patient expectations. No themes were enablers. Confidence ratings were moderate or low. CONCLUSIONS: Synthesising available data revealed barriers that collectively point towards a need to address clinician knowledge gaps, and enhance clinician communication and behaviour change skills to facilitate patient adherence, enable effective conversations and manage dissonant patient expectations. REGISTRATION: PROSPERO (http://www.crd.york.ac.uk/PROSPERO) [4/11/2015, CRD42015027543].

Physical characterization of titanium dioxide nanoparticles.

OBJECTIVE: The objective of this study was to review six measurement methods (X-ray line broadening, electron microscopy, static light scattering, dynamic light scattering, X-ray sedimentation and surface area determination), which are widely used for the characterization of ultrafine inorganic oxides used in cosmetic formulations. Depending on the processing that they have received and the system in which they are examined, these oxides can exist as primary particles, strongly bound aggregates or weakly bound agglomerates. METHODS: The example of titanium dioxide, TiO2 , is used to consider which type of particle is being measured in a particular case, and the factors which influence the 'size' that is generated by a particular method. Where appropriate, a correlation is made between results of different measurements. RESULTS: Results for a particular set of four cosmetic grade TiO2 's are presented and examined, in the context of a much broader set of measurements taken from the scientific literature. CONCLUSION: In general, X-ray line broadening, electron microscopy and surface area measurements led to estimates of the size of primary particles. By contrast, both sedimentation and light scattering measurements measured the size of the secondary particles, and the figures which were generated depended on the dispersion conditions used for preparation of the measurement samples. For poorly dispersed or lightly milled samples, the size may be dominated by the presence of weakly bound agglomerates, but even when the sample is well dispersed or heavily milled, the reported size cannot be less than that of the aggregates.

Patient experiences with physiotherapy for knee osteoarthritis in Australia-a qualitative study.

OBJECTIVE: Physiotherapists commonly provide non-surgical care for people with knee osteoarthritis (OA). It is unknown if patients are receiving high-quality physiotherapy care for their knee OA. This study aimed to explore the experiences of people who had recently received physiotherapy care for their knee OA in Australia and how these experiences aligned with the national Clinical Care Standard for knee OA. DESIGN: Qualitative study using semistructured individual telephone interviews and thematic analysis, where themes/subthemes were inductively derived. Questions were informed by seven quality statements of the OA of the Knee Clinical Care Standard. Interview data were also deductively analysed according to the Standard. SETTING: Participants were recruited from around Australia via Facebook and our research volunteer database. PARTICIPANTS: Interviews were conducted with 24 people with recent experience receiving physiotherapy care for their knee OA. They were required to be aged 45 years or above, had activity-related knee pain and any knee-related morning stiffness lasted no longer than 30 min. Participants were excluded if they had self-reported inflammatory arthritis and/or had undergone knee replacement surgery for the affected knee. RESULTS: Six themes emerged: (1) presented with a pre-existing OA diagnosis (prior OA care from other health professionals; perception of adequate OA knowledge); (2) wide variation in access and provision of physiotherapy care (referral pathways; funding models; individual vs group sessions); (3) seeking physiotherapy care for pain and functional limitations (knee symptoms; functional problems); (4) physiotherapy management focused on function and exercise (assessment of function; various types of exercises prescribed; surgery, medications and injections are for doctors; adjunctive treatments); (5) professional and personalised care (trust and/or confidence; personalised care) and (6) physiotherapy to postpone or prepare for surgery. CONCLUSION: Patients' experiences with receiving physiotherapy care for their knee OA were partly aligned with the standard, particularly regarding comprehensive assessment, self-management, and exercise.

A novel electrochemical device for the disinfection of fluids by OH radicals.

This paper describes a novel, composite device, based not on optical excitation but on the transfer of holes from Si to the TiO(2)/air or TiO(2)/water interface, for the disinfection and detoxification of fluid streams.

New TiO2/C sol-gel electrodes for photoelectrocatalytic degradation of sodium oxalate.

This paper reports the preparation of carbon doped TiO2 electrodes by a modification of a sol-gel route. The electrodes have been characterized by measuring their photocurrent, as a function of applied potential. Their photoelectrocatalytic activity, relative to similar sol-gel electrodes without carbon, has been assessed by measuring the decomposition of a 10 mM sodium oxalate solution. Measurements have been made on electrodes prepared with 2%, 5% and 10% of active carbon. The highest photocurrents and the highest photoelectrocatalytic activity were both obtained with electrodes prepared by heating, at 600 degrees C, electrodes prepared with 5% of active carbon. All the electrodes showed evidence of enhanced photocatalytic activity at 1.2 V. Five percent addition of C double the measured rates of photodegradation, even though, in these preliminary studies, no attempt has been made to optimize the type of carbon or the details of the electrode preparation.

Barriers and enablers in primary care clinicians' management of osteoarthritis: protocol for a systematic review and qualitative evidence synthesis.

INTRODUCTION: Osteoarthritis is a highly prevalent and disabling condition. Primary care management of osteoarthritis is generally suboptimal despite evidence for several modestly effective interventions and the availability of high-quality clinical practice guidelines. This report describes a planned study to synthesise the views of primary care clinicians on the barriers and enablers to following recommended management of osteoarthritis, with the aim of providing new interpretations that may facilitate the uptake of recommended treatments, and in turn improve patient care. METHODS AND ANALYSIS: A systematic review and meta-synthesis of qualitative studies. 5 databases will be searched using key search terms for qualitative research, evidence-based practice, clinical practice guidelines, osteoarthritis, beliefs, perceptions, barriers, enablers and adherence. A priori inclusion/exclusion criteria include availability of data from primary care clinicians, reports on views regarding management of osteoarthritis, and studies using qualitative methods for both data collection and analysis. At least 2 independent reviewers will identify eligible reports, conduct a critical appraisal of study conduct, extract data and synthesise reported findings and interpretations. Synthesis will follow thematic analysis within a grounded theory framework of inductive coding and iterative theme identification. The reviewers plus co-authors will contribute to the meta-synthesis to find new themes and theories. The Confidence in the Evidence from Reviews of Qualitative research (CERQual) approach will be used to determine a confidence profile of each finding from the meta-synthesis. The protocol has been registered on PROSPERO and is reported using the Preferred Reporting Items for Systematic Review and Meta-Analyses Protocols (PRISMA-P) guidelines. ETHICS AND DISSEMINATION: Ethical approval is not required. The systematic review will be published in a peer-reviewed journal. The results will help to inform policy and practice and assist in the optimisation of management for people with osteoarthritis. PROSPERO REGISTRATION NUMBER: CRD42015027543.