The story so far………- current opinion in the use and applications of interactive storytelling in physiology and clinical education.

Physiology and clinical practice are subjects of study which demand integration of multiple sources of systems working knowledge and information on the performance of those systems to come to meaningful conclusions. This is made more complex by the interpretation and actions as a result of this conclusion having direct impact on the sum of the component systems, the human, thereby integrating significant social and psychological considerations into an already complex situation. As higher education educators, it is a significant challenge to provide our learners with training and most importantly, practice, in these knowledge, skills and behaviours in the classroom. There has been a significant interest in recent years in providing active learning opportunities which allow learners to apply subject knowledge to multi-faceted, immersive, continuously evolving stories which reflect a graduate's professional aspirations. This review highlights practices from the literature of storytelling education which the higher education educator can utilise in promoting "meaning making" in the classroom. Here, the case for interactive storytelling in physiology and clinical education is argued, as well as presenting commonly utilised techniques and practices with which educators can embed storytelling into their pedagogy as well as highlighting future directions in this field

Criminal law and criminal justice: morals and policy

Criminal Law and Criminal Justice: Morals and Policy goes beyond the traditional criminal law textbook and invites students to examine underpinning theory. It questions why we criminalise certain behaviour and whether the decisions made by the courts can be justified according to legal principle, morals and policy. Providing an overview not only of the legal doctrine of criminal law, but also of the underpinning theory behind the legal doctrine, the book encourages critical thinking around the context behind and implementation of legal decisions. It applies this to current issues, such as respect for personal autonomy, prevention of domestic abuse and discouraging gang activity, whilst providing a clear overview of the law relating to actus reus, mens rea, property offences, homicide, non-fatal offences, sexual offences, accessorial liability, and defences. Using hypothetical scenarios students will develop an understanding of why certain rules exist and then be able to critically analyse why certain behaviour is criminalised. An in-depth study of several key cases will show how the rules and theory play out in practice and students will examine how morals and policy have influenced these decisions. Featuring thinking points as well as further reading suggestions, this textbook is suitable for all students of criminal law, as well as for those studying jurisprudence

The sustained attention paradox: a critical commentary on the theoretical impossibility of perfect vigilance

The human capacity for sustained attention represents a critical cognitive paradox: while essential for numerous high-stakes tasks, perfect vigilance is fundamentally impossible. This commentary explores the theoretical impossibility of maintaining uninterrupted attention, drawing from extensive interdisciplinary research in cognitive science, neuroscience, and psychology. Multiple converging lines of evidence demonstrate that sustained attention is constrained by neural, biological, and cognitive limitations. Neural mechanisms reveal that attention operates through rhythmic oscillations, with inherent fluctuations in frontoparietal networks and default mode network interactions. Neurochemical systems and cellular adaptation effects further underscore the impossibility of continuous, perfect vigilance. Empirical research across domains—including aviation, healthcare, industrial safety, and security—consistently demonstrates rapid declines in attention performance over time, regardless of individual expertise or motivation. Even elite performers like military personnel and experienced meditators exhibit inevitable attention lapses. This paper presents an argument against traditional approaches that seek to overcome these limitations through training or willpower. Instead, it advocates for designing human-technology systems that work harmoniously with cognitive constraints. This requires developing adaptive automation, understanding individual and cultural attention variations, and creating frameworks that strategically balance human capabilities with technological support

“You don't have to be a survivor of abuse to be worried about smears”: cervical screening experience of forensic inpatients.

Purpose: Childhood trauma, especially sexual abuse is linked to higher health risks including cervical cancer. Forensic inpatients often have complex trauma histories placing them at increased risk of cervical cancer. The uptake of screening in patient forensic inpatient services is sub-optimal, although little is known about their experiences. This study focuses on the cervical screening experiences of people nursed in forensic service inpatients. This group present with unique health challenges and are an under-researched and vulnerable population with a higher risk of cervical cancer Method: A qualitative study used purposive sampling to recruit eight participants from two NHS secure forensic services. All participants were inpatients detained under the Mental Health Act (1983, revised 2007) in Women’s pathways. Data was collected through semi-structured interviews and was analysed using Interpretive Phenomenological Analysis. Results: Two superordinate themes were developed: (1) Internal Conflict linked past experiences to screening beliefs, and (2) Manufacturing Control showed how individuals employed strategies to feel psychological ready for screening. Conclusion: This study aimed to understand the facilitators and barriers to cervical screening among forensic in-patients and identify ways to improve their experiences to increase engagement in screening. The results identify how participants experiences prior to and within forensic services impact cervical screening uptake. Forensic inpatients require psychological readiness and feelings of control and safety to engage in cervical screening to minimise examinations reminding or re-enacting their trauma history. Systemic factors can enhance safety perceptions and encourage screening in this group

Anthocyanin-rich blackcurrant supplementation as a nutraceutical ergogenic aid for exercise performance and recovery: A narrative review

Athletes and physically active individuals consume sports nutrition supplements to enhance competitive sport performance and exercise recovery. Polyphenols have emerged as a promising area of research with application for sport and exercise nutrition due to affecting physiological mechanisms for exercise performance and recovery. The anthocyanin is a polyphenol that can be abundantly present in dark-colored fruits, berries and vegetables. Anthocyanins and anthocyanin-induced metabolites will provide antioxidant and anti-inflammatory effects. The focus in this narrative review is on the observations with intake of anthocyanin-rich blackcurrant supplements on whole-body exercise performance and exercise recovery. This review included a total number of 17 studies with a randomized placebo-controlled cross-over design (10 studies on performance and 8 on recovery effects) and 1 with a randomized placebo-controlled parallel group design (recovery effects). Among the performance studies, 6 studies (60%) reported positive effects, 3 studies (30%) reported no significant effects and 1 study (10%) reported a mixed outcome. Among the recovery studies, 7 studies (78%) reported positive effects, 1 study (11%) reported no significant effects and 1 study (11%) reported a negative effect. Studies with intake of supplements made from New Zealand blackcurrants (dose: 1.8 to 3.2 mg·kg-1 and 105 to 315 mg of anthocyanins, acute to 7-day intake) have provided meaningful (but not always consistent) effects on continuous and intermittent exercise performance tasks (i.e. rowing, cycling and running) and markers for exercise recovery. A mechanistic understanding for the beneficial exercise effects of anthocyanins for athletes and physically active individuals is still limited. Future work requires a better understanding of the specific types of anthocyanins and anthocyanin-induced metabolites and their effects on altering cell function that can enhance exercise performance and recovery

Task difficulty promotes tactical learning but supresses the positive learning effects of autonomy and cognitive effort

Learning conditions that provide task-relevant autonomy, and those that encourage cognitive effort through manipulations of difficulty, have been reported to enhance skill development. However, research is yet to directly compare these two manipulations to establish their relative contribution to enhancing motor learning. This study used an on-screen target interception task to compare an autonomous group (self-selection of racquet size), a Challenge Point group (performance-contingent racquet size), a yoked group, and a fixed racquet size control group. Task accuracy and self-report measures of intrinsic motivation and cognitive effort were recorded at multiple time points across acquisition and at immediate, 24-h, seven-day, and 30-day retention and transfer tests. Results showed that task accuracy improved over acquisition, and remained robust across all retention tests, but no between group differences were seen. Intrinsic motivation levels decreased over acquisition, but with no between group differences observed. Participants (83, mean age 40(±12) years, 50 % male) within all groups reported consistently high cognitive effort scores, and made tactical learning choices, suggesting that high task difficulty may have suppressed the more subtle effects of autonomy and performance contingent practice. Conclusions are made regarding the variability of individual approaches to a novel task and the need to build experiments that can detect these idiosyncrasies

Individual responses to encapsulated caffeine and caffeine chewing gum on strength and power in strength-trained males

Background: Liquid-dissolved and encapsulated powder are two popular ways to consume caffeine for performance-enhancing effects. Caffeine in other delivery methods, such as chewing gums, orally dissolvable strips, gels, mouthwashes, energy drinks, and nasal sprays, is believed to be absorbed more quickly into the bloodstream. Inter-individual responses to caffeine's enhancing effects are recognized. The present study examined the inter-individual responses to the acute effects of encapsulated caffeine and caffeinated chewing gum on the lower-body isokinetic and isometric strength and power in strength-trained males. Method: A randomized, cross-over, placebo-controlled study was conducted with fifteen strength-trained males (age: 25±4 years, height: 176±7 cm, weight: 75±11 kg, habitual caffeine intake: 66±15 mg·day⁻¹). Participants were randomly assigned to three conditions: i) caffeinated chewing gum (CG), ii) caffeine capsule (CC), and iii) starch capsule as a placebo (PLA). Participants consumed approximately 3 to 4.5 mg·kg⁻¹ of caffeine 60 minutes before testing. The washout period between conditions was one week. Participants performed the Sargent jump test, followed by a 5-minute active recovery (walking). Subsequently, isokinetic strength and power (60°/s and 180°/s) and isometric strength (45° and 60°) parameters were measured for knee extensor and flexor muscles. Data were analyzed using one-way repeated measures ANOVA and Bonferroni post hoc tests, with significance set at P ≤ 0.05. Responders to the caffeine conditions were identified using the smallest worthwhile change (SWC) analysis. Results: In knee extensors, 1) average peak torque and power at 60°/s were higher in CC (P=0.045; +11.22% and P=0.038; +14.15%) and CG (P=0.044; +7.32% and P=0.015; +11.42%) compared to PLA with a co-response rate of 60% and 66%, 2) maximum voluntary isometric contraction at 45° (MVIC-45°) was higher in CC compared to PLA (P=0.031; +10.15% ), and 3) MVIC-60° was higher in CG compared to PLA (P=0.037; +10.15%) with a co-response rate of 60%. In knee flexors, 1) time to peak torque at 60°/s was higher in CG compared to PLA (P=0.011; +18.28%) with a co-response rate of 46%, 2) average rate of force development at 60°/s was higher in CC (P=0.007; +24.14%) and CG (P=0.050; +20.69%) compared to PLA with a co-response rate of 53%, and 3) average power at 180°/s was higher in CC compared to PLA (P=0.033; +18.08%) with a co-response rate of 46%. However, there were no differences between other strength indicators in the knee extensors and flexors between the different conditions. Vertical jump height (VJH) was higher in CC (P=0.001; +5.58%) and CG (P=0.001; +6.09%) compared to PLA, with a co-response rate of 53%. Conclusion: Caffeine supplementation in CC and CG forms significantly enhanced lower-body strength, power, and vertical jump height in strength-trained males, with over ~ 50% of participants exceeding the SWC thresholds across key performance metrics. CC showed slightly higher responder rates for strength parameters, while CG excelled in time-dependent measures, supporting their use as effective and flexible ergogenic aids

Effects of root extract of Ashwagandha ( Withania somnifera ) on perception of recovery and muscle strength in female athletes

Ashwagandha is a supplement with the potential to improve exercise performance. However, research on its impact on female athletes remains limited. This study investigates the effects of ashwagandha on exercise recovery and muscle strength in professional female athletes, addressing a gap in understanding its role in this underrepresented population. Female footballers were randomly assigned to a 600 mg/day ashwagandha root extract group (ASH, n = 15; age: 26.0 ± 4.9 years, height: 1.66 ± 0.1 m, body mass: 61.5 ± 7.5 kg, and career: 15.2 ± 7.4 years) or a placebo group (PLA, n = 15; age: 23.5 ± 5.5 years, height: 1.66 ± 0.1 m, body mass: 61.5 ± 6.0 kg, and career: 13.1 ± 4.9 years). Recovery was assessed with total quality recovery (TQR), Hooper Index (HI) and rate of perceived exertion (RPE). Strength was assessed by hand grip, medicine ball throw (MBT), countermovement jump (CMJ) and peak power. Dietary intake was recorded prior to baseline measurements. Repeated measures ANOVA, Bonferroni test, independent t‐tests and ANCOVA were used in the analysis. A significant group × time interaction effect was found for TQR (p = 0.026), with the post‐hoc analysis revealing a significant difference between ASH and PLA at 28 days (p = 0.039). Perceived sleep quality from HI improved significantly in ASH compared to PLA (p = 0.038), with a significant change at 14 days. The ANCOVA analysis highlighted the significant influence of carbohydrate intake on hand grip strength (p = 0.005), MBT (p < 0.001) and body mass (p < 0.001). A dosage of 600 mg of ashwagandha root extract for 28 days may improve TQR and enhance perceived sleep quality in female footballers. Future research should investigate the optimal dosage and test across a broader range of athletic populations. Trials Registration: The trial is registered on ClinicalTrials.gov with the ID NCT0626498

The effects of acute exercise on memory: considerations for exercise duration and participant body mass index

Acute moderate-intensity exercise has been demonstrated to improve memory performance. It is less clear, however, whether the duration of acute exercise and body mass index (BMI) may moderate this effect. Thus, the purpose of this experiment was to evaluate the effects of differing exercise durations (20- and 40-minutes) on immediate and long-term memory performance, while considering BMI as a moderating factor in this exercise duration and memory performance relationship. Twenty-three young healthy adults participated in a within-subjects experiment. Participants completed four different experimental visits including either exercising at a moderate intensity (or standing on a treadmill) for 20- or 40-minutes, followed by an immediate free-recall memory assessment and then a delayed 24-hr recall. Acute moderate-intensity exercise improved memory performance, regardless of the duration of exercise. Further, long-term memory performance was greater for individuals with a higher BMI when they engaged in shorter (20 min) exercise compared to longer (40 min) exercise

Soldier performance management: insights from boots on ground research and recommendations for practitioners

Theoretically, the serial measurement of biomarkers to monitor physiological responses to military training could be used to mitigate musculoskeletal injury risk and better understand the recovery status of personnel. To date, the cost and scalability of these initiatives have impeded their uptake by defence organisations. However, advances in technology are increasing the accessibility of a range of health and performance biomarkers. This paper presents a synthesises of findings from the literature and discussions with informed stakeholders to provide contextually relevant advice for future efforts to monitor military personnel, together with key considerations to ensure actionable outcomes from the data captured. The aim of this review is, therefore, twofold; first, to demonstrate how wearable devices and biomarkers have been used in defence research to assess the context-specific, occupational demands placed on personnel; and second, to discuss their potential to monitor military workloads, optimise training programming and understand soldier adaptation to multi-stressor environments