Background
There is overwhelming evidence to support the promotion of physical activity in adults in terms of benefits to well-being, physical and mental health. Physical activity guidelines suggest that adults should accumulate at least 150 min of moderate to vigorous physical activity per week. In Ireland, the majority of adults do not achieve these guidelines, with costs to health and economy. ‘Move for Life’ (MFL) employs behavioural change techniques delivered by an instructor and peer mentor, using a train-the-trainer (cascade) model. This study will conduct a feasibility cluster randomised controlled trial of the MFL intervention for modifying physical activity behaviours in inactive adults aged 45 years and older.
Methods
The trial is set in eight Local Sports Partnership (LSP) hubs that have structured physical activity programmes. The hubs are the units of randomisation (clusters), and individuals are the units of analysis (participants). Eligible participants will contact one of the hubs, with each hub running four physical activity programmes. Each programme requires between 12–15 inactive adults, resulting in 48–60 participants per hub. Allowing for 20% dropout rate, an additional 96 people will be recruited giving a maximum sample of 576. The hub will be randomised: true control, usual programme or MFL intervention. The true control group will be given information about physical activity but will not be included in a programme for the duration of the trial; the intervention will involve the instructor training one (or more) of the participants to be a peer mentor using an educational toolkit; and usual care groups will have physical activity classes delivered as normal. Baseline data will collect physical activity measures and follow-up measurements will be obtained at 3 and 6 months. All participants will be asked to wear a device for measuring activity on the thigh (activPAL) for 7 days before commencing the programme and at 3 and 6 months. The primary objective of the study is to investigate if it is feasible to deliver the intervention and collect data on moderate to vigorous physical activity (MVPA) on all participants, thereby providing valuable information to guide sample size calculation for a future, more definitive trial.
Trial registration number
ISRCTN11235176
Electronic supplementary material
The online version of this article (10.1186/s40814-019-0473-y) contains supplementary material, which is available to authorized users.
A woman in her 30s with severe BD presented with a new onset of painful and pruritic facial eruption during the early third trimester of her pregnancy. It progressively extended to her neck and upper arms.
which was observed in our patient. Nevertheless, the diagnosis of POEMS syndrome-associated multicentric Castleman disease was not supported by the absence of peripheral neuropathy in our case. 3 Prior to anakinra treatment, we treated the patient with tocilizumab, 4 which only partially improved urticarial rash on the localized erythematous patches. On the other hand, the administration of anakinra demonstrated prompt favourable responses to clinical manifestations. 2 Taken together, although the possibility of Castleman disease and cutaneous plasmacytosis cannot be completely excluded, our case is considered as Schnitzler syndrome.We agree with the insightful notion by Dr Wang that skinassociated lymphoid tissue (SALT) can be formed under the influence of hypercytokinaemia as a sign of systemic disease. Therefore, we termed these lymphoid follicles as inducible SALT (iSALT). It is yet to be elucidated whether iSALT formation is a characteristic of Schnitzler syndrome or a unique phenomenon detected in our patient, who manifested wheals on recurrent localized erythema, which is not commonly observed in Schnitzler syndrome. We believe that further investigation is required to clarify the pathogenesis and the function of iSALT in various skin diseases. Acknowledgments: We thank Dr Prof. H. Kawabata of Kanazawa Medical University for his informative guidance about the diagnosis of Castleman disease.
Referees are the backbone of quality control. They need more recognition for their work. In an open exchange of opinions among a number of leading editors and experienced reviewers one suggestion has wide support: It should no longer be 'free' to submit a manuscript to a scientific journal. While cash payment for reviews is not considered a good idea, a 'payback in kind' system is favored: i.e., if you want to submit papers to a journal you must be willing to review for that journal.
Highlights: the consultation on the draft framework gave rise to themes in relation to the content of the framework, communication issues, and implementation issues. Themes included:
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