BackgroundHuntington's disease (HD) is a fatal inherited neurodegenerative disease, caused by a

Background Digital technologies such as wearables, websites and mobile applications are increasingly used in interventions targeting physical activity (PA). Increasing access to such technologies makes an attractive prospect for helping individuals of low socioeconomic status (SES) in becoming more active and healthier. However, little is known about their effectiveness in such populations. The aim of this systematic review was to explore whether digital interventions were effective in promoting PA in low SES populations, whether interventions are of equal benefit to higher SES individuals and whether the number or type of behaviour change techniques (BCTs) used in digital PA interventions was associated with intervention effects. Methods A systematic search strategy was used to identify eligible studies from MEDLINE, Embase, PsycINFO, Web of Science, Scopus and The Cochrane Library, published between January 1990 and March 2020. Randomised controlled trials, using digital technology as the primary intervention tool, and a control group that did not receive any digital technology-based intervention were included, provided they had a measure of PA as an outcome. Lastly, studies that did not have any measure of SES were excluded from the review. Risk of Bias was assessed using the Cochrane Risk of Bias tool version 2. Results Of the 14,589 records initially identified, 19 studies were included in the final meta-analysis. Using random-effects models, in low SES there was a standardised mean difference (SMD (95%CI)) in PA between intervention and control groups of 0.06 (− 0.08,0.20). In high SES the SMD was 0.34 (0.22,0.45). Heterogeneity was modest in both low (I2 = 0.18) and high (I2 = 0) SES groups. The studies used a range of digital technologies and BCTs in their interventions, but the main findings were consistent across all of the sub-group analyses (digital interventions with a PA only focus, country, chronic disease, and duration of intervention) and there was no association with the number or type of BCTs. Discussion Digital interventions targeting PA do not show equivalent efficacy for people of low and high SES. For people of low SES, there is no evidence that digital PA interventions are effective, irrespective of the behaviour change techniques used. In contrast, the same interventions in high SES participants do indicate effectiveness. To reduce inequalities and improve effectiveness, future development of digital interventions aimed at improving PA must make more effort to meet the needs of low SES people within the target population.

Introduction: Across the United Kingdom, physiotherapy for critical care patients is provided 24 h a day, 7 days per week. There is a national drive to standardise the knowledge and skills of physiotherapists which will support training and reduce variability in clinical practice. Methods: A modified Delphi technique using a questionnaire was used. The questionnaire, originally containing 214 items, was completed over three rounds. Items with no consensus were included in later rounds along with any additional items suggested. Results: In all, 114 physiotherapists from across the United Kingdom participated in the first round, with 102 and 92 completing rounds 2 and 3, respectively. In total, 224 items were included: 107 were deemed essential as a minimum standard of clinical practice; 83 were not essential and consensus was not reached for 34 items. Analysis/Conclusion: This study identified 107 items of knowledge and skills that are essential as a minimum standard for clinical practice by physiotherapists working in United Kingdom critical care units.

Diagnostic thinking relates to the cognitive processes that result in a diagnosis following examination/ assessment of a patient. Researchers, both medical and educational, have investigated these processes of diagnostic thinking (Barrows & Bennett, 1972; Grant & Marsden 1987) and foUowing this Bordage, Grant & Marsden (1990) developed an inventoy that could quantitatively measure diagnostic thinking ability in medical doctors. This study assessed the Bordage, Grant & Marsden diagnostic thinking inventoy for its reliability and validity for use with physiotherapists, who follow similar diagnostic pathways to medical doctors (Jette, 1989). Reliability was assessed using the test-retest method and measurement of internal consistency by Cronbach's alpha. The invento y was reviewed by experts in the field of physiotherapy to consider its content validity. Construct validity was judged by looking for differences in the responses of stdent and qualified physiotherapists who are assumed to differ in their diagnostic ability. The results showed that the invento y is a reliable and valid instrument for measuring diagnostic ability in physiotherapists working in an outpatient department. Correlation plots indicated a positive relationship between scores on test and retest, this relationship being statistically signifcant (r = 0.779, p < 0.001). The inventoy had internal consistency with an overall alpha value of 0.846. Experts in the field of physiotherapy agreed that the invento y measured diagnostic thinking which ensured content validity of the inventoy. Statistical differences were found between the responses of student and qualijied physiotherapists with a t value of -3.79 (p < 0.001) for total scores thus indicating construct validity.Further work needs to be carried out to assess the reliability and validity of the inventoy for physiotherapists in other specialist areas. It is foreseen that this inventory may be used to measure diagnostic thinking in physiotherapists and to measure outcomes of educational programmes designed to improve diagnostic thinking.

Background