ABSTRACT
BACKGROUND: Evidence for benefits of physical activity after stroke is unequivocal. However, many people with stroke are inactive, spending > 80% of waking hours sedentary even when they have physical capacity for activity, indicating barriers to physical activity participation that are not physical. WeWalk is a 12-week person-centred dyadic behaviour change intervention in which a person with stroke (PWS) and a walking buddy form a dyad to work together to support the PWS to increase their physical activity by walking outdoors. This pilot study examined the feasibility of recruiting dyads, explored their perceptions of acceptability and their experiences using WeWalk, to identify required refinements before progression to a clinical trial. METHODS: Design: A single-arm observational pilot study with qualitative evaluation. INTERVENTION: WeWalk involved facilitated face-to-face and telephone sessions with a researcher who was also a behaviour change practitioner, supported by intervention handbooks and diaries, in which dyads agreed walking goals and plans, monitored progress, and developed strategies for maintaining walking. EVALUATION: Descriptive data on recruitment and retention were collected. Interview data were collected through semi-structured interviews and analysed using thematic analysis, guided by a theoretical framework of acceptability. RESULTS: We recruited 21 dyads comprising community dwelling PWS and their walking buddies. Ten dyads fully completed WeWalk before government-imposed COVID-19 lockdown. Despite lockdown, 18 dyads completed exit interviews. We identified three themes: acceptability evolves with experience, mutuality, and person-centredness with personally relevant tailoring. As dyads recognised how WeWalk components supported walking, perceptions of acceptability grew. Effort receded as goals and enjoyment of walking together were realised. The dyadic structure provided accountability, and participants' confidence developed as they experienced physical and psychological benefits of walking. WeWalk worked best when dyads exhibited relational connectivity and mutuality in setting and achieving goals. Tailoring intervention components to individual circumstances and values supported dyads in participation and achieving meaningful goals. CONCLUSION: Recruiting dyads was feasible and most engaged with WeWalk. Participants viewed the dyadic structure and intervention components as acceptable for promoting outdoor walking and valued the personally tailored nature of WeWalk. Developing buddy support skills and community delivery pathways are required refinements. ISCTRN number: 34488928.
ABSTRACT
The article offers information on the benefits and limitations of online mindfulness-based interventions for people experiencing mental health issues. Topics discussed include background on mindfulness-based interventions, effectiveness of online mindfulness interventions in healthcare settings, and concerns regarding mindfulness-based interventions.
ABSTRACT
In this case report, we describe a previously healthy eleven-year-old male diagnosed with multisystem inflammatory syndrome in children (MIS-C) associated with coronavirus disease 2019. The patient presented with shock and neurologic symptoms including altered mental status and dysarthria. Brain magnetic resonance imaging, obtained to rule out thromboembolic injury, demonstrated cytotoxic edema of the corpus callosum, an imaging finding similar in nature to several previous reports of MRI abnormalities in children with MIS-C. Following administration of intravenous immunoglobulin and pulse-dose steroids, the patient convalesced and was discharged home. Medications prescribed upon discharge included a steroid taper, daily aspirin, and proton pump inhibitor. Four days later, he was readmitted with shock and life-threatening gastrointestinal (GI) hemorrhage. After extensive evaluation of potential bleeding sources, angiography revealed active bleeding from two arterial vessels supplying the duodenum. The patient demonstrated no further signs of bleeding following successful coil embolization of the two vessels. We hypothesize that the vasculitic nature of MIS-C combined with anti-inflammatory and antithrombotic therapy placed him at risk of GI hemorrhage. This case highlights unique radiologic features of MIS-C as well as potential complications of treatment.
ABSTRACT
Since initial identification of severe acute respiratory syndrome coronavirus 2 in 2019, the virus has proved to be highly transmissible, resulting in a global pandemic with emerging reports of infected neonates. This report highlights a severe case of neonatal coronavirus disease 2019 with acute respiratory distress syndrome.