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Accessible Summary: Hobbies that are active can be a way of improving physical and mental well‐being for people with learning disabilities.Choice, tailoring an activity to a person's needs and companionship between people with learning disabilities and their caregivers can facilitate participation in hobbies that are active.Disregard for a person's physical and cognitive capabilities, and for their environmental or carer circumstances, can hinder participation in hobbies that are active. Background: Active recreation denotes engagement with meaningful and rewarding activities that can improve physical and mental well‐being for everyone; however, there are specific challenges to participation in active recreation for people with learning disabilities. Aim: To understand what hinders and what enables participation in active recreation for people with learning disabilities. Method: Using a scoping review framework, we retrieved relevant literature by searching MEDLINE 1946 (Ovid), PsycINFO, CINAHL Complete (EBSCO), Scorpus, PubMed and Web of Science. We extracted data, charted and synthesised them using the Model of Human Occupation (Kielhofner, 2008) and the social–ecological model (Boulton, Horne & Todd, 2017). Findings: Nineteen studies met our inclusion criteria. Key barriers identified in the studies included caregiver/coach knowledge and skill, caregiver resources, relational, environmental and individual capabilities. Key facilitators included choice, needs‐based tailored activities, positive relationships, consideration of cognitive and functional ability, motivational incentives and policy and organisational factors. Conclusions: Participation in active recreation involves a complex interaction between individuals with learning disabilities, their caregivers and their wider organisational and community networks. This relationship warrants further exploration from the perspective of people with learning disabilities and their proxies, so that we can optimise how we design and deliver active recreational pursuits for this population. [ABSTRACT FROM AUTHOR]

Background: The study evaluated European Medicines Agency (EMA) recommendations on communicating frequency information on side‐effect risk. Methods: The study used a 2 × 2 factorial trial, with random allocation of information about 10 side‐effects of paclitaxel (Taxol) expressed using one of four formats. Recruitment was via the CancerHelpUK website. Information was conveyed using numerical frequency bands (e.g. ‘may affect up to 1 in 10 people’) or combined verbal terms and numerical bands (e.g. ‘common: may affect up to 1 in 10 people’); in addition, the risk qualifier verb was manipulated, with risks expressed either as ‘will affect…’ or ‘may affect…’. Participants then made six side‐effect frequency estimates indicated their satisfaction with the information and evaluated the side‐effects: how bad; how likely; how risky to health; and their influence on taking paclitaxel. Results: The sample comprised 339 people, of whom 37.5% had cancer. The combined verbal and numerical risk expressions resulted in higher estimates of side‐effects, four of which reached statistical significance (P < 0.05), and participants also said that side‐effects would be more likely. Use of ‘may affect’ or ‘will affect’ did not result in differences in any estimates. Conclusions: This is the first evaluation of the full range of combined verbal and numerical risk expressions recommended in EMA guidance; it demonstrates that they can lead to significant risk overestimations when compared to numerical frequency bands alone. The EMA should consider revising its guidance. Government agencies and professional bodies should be cautious about recommendations for risk communication in the absence of empirical evidence. [ABSTRACT FROM AUTHOR]

The article presents the research that explores on the perspectives of African Americans and ethnic minority patients on the self-management of diabetes in Great Britain. The topics discussed include the barriers they experienced in managing their ailments and the importance of their insights in improving the healthcare services and policies.

Objectives To revise and improve an existing scale to measure health practitioners’ attitudes to partnership in medicine taking and to ascertain the views of medical students, nursing students and pre-registration pharmacists on concordance. Background The traditional model of the practitioner-patient interaction incorporates a practitioner-centred approach, focusing on the disease rather than the patient. The philosophy of ‘concordance’ (or ‘partnership in medicine-taking’) puts the patient at the centre of the interaction, with the patient interacting reciprocally with the practitioner. The Leeds Attitude to Concordance (LATCon) scale was developed in 2001 to assess practitioners’ and patients’ attitudes to concordance. However, thinking on concordance has developed since then and the present study aimed to revise the scale to ensure that it reflected current thinking and also to increase its reliability and validity. Design A pool of potential items was developed and sent to three subject experts for opinion. An attitudinal Likert scale of 31 items was developed. Its completion was followed by statistical item reduction to 20 items. The shorter scale was completed by the same participants 4–6 weeks later. Setting and participants The study was set in a university in the UK. Participants were 183 medical students, nursing students, and pre-registration pharmacists. Results and discussion The study derived a 20 item scale, including five negatively-worded items, with good levels of internal and test-retest reliability. Factor analysis suggested five main factors. A statistically significant difference in attitudes was found between student nurses and medical students, and student nurses and pre-registration pharmacists, with student nurses being more in agreement with the concordant approach. Overall, participants were in agreement with the concordant approach to medicine taking. The UK National Health Service advocates partnership in medical care and is encouraging both practitioners and patients to work to introduce this. There is increased awareness of the patients’ perspective by practitioners, but its impact on their practice remains unclear. Education and skills teaching must continue for the benefits of a concordant approach to be seen. The LATCon scale could play a useful role in education and training, and in research assessing the movement towards the new approach. [ABSTRACT FROM AUTHOR]

Aims There are still controversies regarding the reproducibility of cystometric data and no objective measurement of bladder sensations is currently available. Additionally, very little information exists about autonomic activity during standard filling cystometry (FC). The aim of this study was to evaluate the use of heart rate variability (HRV) analysis as a reliable monitor of the autonomic nervous system and objective measure for bladder sensations during FC. Methods In a volunteer sample of healthy female subjects a standard FC at 25 ml/min was performed, using an 8 Fr microtip catheter with integrated pressure transducers. During FC, subjects had to indicate first sensation of filling (FSF), first desire to void (FDV) and strong desire to void (SDV). A 3-lead electrocardiogram was continuously recorded. After 5 h all measurements were repeated. Power spectrum analysis was used to analyse HRV, to obtain low frequency (LF) and high frequency (HF) parameters, from which the LF/HF ratio was derived. Results 12 subjects with a mean age of 23.3 ± 2.3 years could be included. 11 of 12 subjects completed both measurement sessions. One subjects had to be excluded, due to irritating urethral discomfort following catheterisation. The LF/HF ratio showed a reproducible activation pattern in the healthy subjects with a stable sympathovagal balance until FDV. Before SDV was indicated, the sympathovagal balance started to shift towards sympathetic activation and caused a significant increase in LF/HF. Conclusion HRV analysis seems to be a useful indicator for the general activation pattern of the sympathovagal balance during FC, correlating the intensity of the bladder filling sensation to stress and sympathetic activation. Neurourol. Urodynam. 28:313-319, 2009. © 2008 Wiley-Liss, Inc. [ABSTRACT FROM AUTHOR]

Objective  To review research on the role and value of written medicines information for patients from the perspective of patients and health professionals. Context  Providing written information to patients about their medicines is acknowledged as a priority but there is poor understanding of how best to meet patients’ needs. Method  A sensitive search strategy was developed to maximize the identification of relevant studies. We used a data extraction form designed to appraise qualitative research. Findings were synthesized into a narrative account. Main results  There were three broad categories of study: those which related to policy initiatives; those where the aim was to increase compliance; and those concerned with using information to support decision-making (‘informed patient’ studies). While the policy initiative and compliance studies reported that, mostly, patients were positive about written information, the ‘informed patient’ studies showed a more complex picture. Patients valued medicines information tailored to their condition. They did not want it to be a substitute for spoken information from their doctor. Not everyone wanted written information but those who did wanted sufficient detail to meet their need. Need varied over time and between patients. The small number of studies relating to health professionals showed widespread ambivalence towards using written information. Some thought it should be brief and simple, only partially disclose side-effects and saw its main role as being to increase compliance. Conclusion  The different perspectives of patients and health professionals, and the diverse and changing information needs of patients pose a challenge to providers of written medicines information. [ABSTRACT FROM AUTHOR]

Aims To study the effects of functional magnetic stimulation of the spinal cord in healthy subjects on somatic and autonomic pathways innervating the anal and the external urethral sphincter, bladder, bladder neck, and rectum. Methods Eight healthy male volunteers gave their written informed consent and underwent functional magnetic stimulation of the thoracolumbar and sacral spinal cord. A two-channel microtip pressure transducer catheter was placed rectally measuring the abdominal and anal sphincter pressure. A three-channel microtip pressure transducer catheter was inserted into the urethra measuring the bladder, the bladder neck, and the external urethral sphincter pressure. A comprehensive protocol of single and repetitive magnetic stimulations was performed. Frequency, location, and duration of stimulation were varied while the intensity of stimulation was adapted to the maximum the subjects could tolerate. In four subjects, the degree of bladder filling was changed and the protocol was repeated when the subjects reported a full bladder and desire to void. Results Continuous magnetic stimulation of the thoracolumbar spinal cord and the sacral roots applied with different frequencies (5, 15, 30, 60, 100 Hz) and different duration of stimulation (10, 30, 120 sec) evoked sphincter contraction of both anal and urethral sphincters. The stimulation could not evoke contractions of the bladder, the bladder neck, or the rectum. Also with filled bladder and present desire to void, the magnetic stimulation could not activate autonomic pathways innervating these structures. Conclusions Considering our results, we suggest that in individuals with preserved sensibility magnetic stimulation of the spinal cord with intensities below the pain threshold is ineffective in activating autonomic nerve fibres innervating bladder, bladder neck, and rectum. Neurourol. Urodynam. 23:148-153, 2004. © 2004 Wiley-Liss, Inc. [ABSTRACT FROM AUTHOR]

Three forms of discontinuity in social structure produce linked analogous problems about aggregates or wholes: discontinuity in units, discontinuity in time, and discontinuity in variables. Problems of macrotheory, of comparative-historical theory, and of levels of theory are analytically equivalent. Discontinuity in processes between different units produces macro-micro problems when processes involving individuals are different from processes involving larger aggregates. Discontinuity in time refers to the fact that in most dynamic processes, time does not appear homogeneous - if a process occurs in a century, that is not necessarily any reason to suppose that 1/100th of the process occurs in a year. Discontinuity in variables refers to the fact that all variables cannot operate coherently in the same explanatory system. These three discontinuities each produce problems of generalization and scope-problems getting from particular observed relationships to the underlying conditions and determinants of those relationships. For example, temporal discontinuity leads to problems of periodization and of stages. These problems are most visible in comparative-historical theory and they can only be resolved by comparative-historical data. [ABSTRACT FROM AUTHOR]

The theoretical origins of the conflict, functionalist and organizational paradigms in sociology are usually seen as distinct. Common elements in the social theories of Marx, Durkheim and Weber are usually seen as common responses to the development of industrial, capitalist, democratic, bureaucratic structures. However, in all three milieus, Hegel's social theory, particularly his theory of the break-up of feudal society, was a looming point of reference. Thus, an inventory of the respective common elements and breaks from Hegel of founding sociological theorists represents one of the simplest ways of relating Marx, Durkheim and Weber to each other and to neighboring disciplines. [ABSTRACT FROM AUTHOR]

Durkheim is commonly viewed as the founder of sociology as an empirical or even a positivist, empiricist discipline. The connection between empirical sociological theory and Marxist, Weberian, symbolic interactionist, phenomenological, hermeneutic, and other tendencies is illuminated by viewing the parallels between Durkheim and Hegel These parallels should not obscure important contrasts, but they include a large number of the most distinctive doctrines of the two theorists. The comparison illuminates relationships within sociology as well as relationships between sociology and such other disciplines as philosophy, history, literary criticism, jurisprudence, theology, or ethics. The importance within Durkheim's milieu of figures who were deeply influenced by Hegel shows that Hegel's influence on Durkheim should not be obscured by current views of Durkheim as a positivist in the tradition of Comte. [ABSTRACT FROM AUTHOR]

The article discusses the relationship between the study of history and social theory and its significance to the social sciences.