Group medians of STAI-S scores before and after intervention amongst highly anxious individuals.

<p>Amongst highly anxious individuals, participants in the intervention group showed a reduction in reported state anxiety while those in the control group showed a modest increase. The difference between pre-post difference scores for each group was significant (i.e. a group by time interaction).</p

High Frequency (Natural log) Means and Standard Error.

<p>High Frequency (Natural log) Means and Standard Error.</p

Participant characteristics.

<p>Participant characteristics.</p

Screen shot of <i>Resilience Builder</i> software training screen and slow breathing pacer.

<p>a) The ball rises for inhalation and falls for exhalation with a longer interval for exhalation. The top graph shows HR, the large amplitude wave indicates slow deep breathing. The lower graph indicates score, which is very high in this case. b) Breathing pacer identical to Resilience Builder yet no feedback is provided.</p

Flow diagram of participant progress through the study.

<p>Figure depicts progress through the stages of the experiment, including when and why participants were excluded. Conforms to CONSORT guidelines <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0046597#pone.0046597-Schulz1" target="_blank">[89]</a>.</p

Group differences in HRV comparing intervention to control.

<p>Group means and standard error for HRV measures during anxious anticipation pre and post intervention. Both HF and LF/HF ratio showed significant group by time interactions. a) Participants in the intervention group increased HF after intervention, whereas those in the control group decreased. b) Participant in the intervention group decreased LF/HF ratio whereas those in the control group increased.</p

Individual Data: Interbeat intervals (IBI) and frequency analysis during Rest period and Slow breathing.

<p>a) IBI during two minutes of resting state. Changes in HR due to respiration, 12–14 breaths per minute, are small and irregular. b) IBI during two minutes of slow breathing. Changes in HR due to respiration, 6 breathes per minute, are large and regular. High amplitude indicates large differences between the slowest beats during exhalation and fastest beats during inhalation. c) Frequency analysis during 5 minutes resting state indicates low amplitude LF and HF (recording is too short to accurately characterise VLF (Malick, 1996)) d) Frequency analysis during 5 minutes slow breathing indicates very high amplitude LF oscillations at the frequency of breathing (10 times per minute or 0.1 Hz).</p

The role of cognitive and physiological factors in the development of MPA.

<p>The interaction of cognitive and emotional factors in the etiology of music performance anxiety. The performance situation is interpreted in line with previous performance experience and cognitive factors, such as pressure to perform. Slow breathing intervention influences level of vagal tone, inhibiting immediate arousal and enhancing approach tendencies. These physiological factors feedback to cortical areas to influence further interpretation of the environment as either threatening or safe. Perceived safety determines behaviour and interpretation of performance, which leads to either dysregulation and anxiety or successful regulation and coping behaviours. Level of anxious response determines future interpretations of performance environment.</p

The experiences of peer-facilitators delivering a physical activity intervention for emergency service workers and their families

Introduction: Emergency service workers (e.g. police, fire, ambulance officers) are regularly exposed to occupational stressors and potentially traumatic events, resulting in an increased risk of poor mental and physical health. For example, emergency service workers are twice as likely to experience suicidal thoughts compared to the general population and one in ten will develop posttraumatic stress disorder. Despite this, emergency service workers face barriers to accessing traditional mental healthcare. Physical activity is non-stigmatising and may help improve the mental and physical health of this population; however, novel ways to help people engage are needed. Peers with lived experience may be well-placed to co-deliver physical activity programs alongside health professionals. The aim of this study was to understand the experiences of peer-facilitators co-delivering an online physical activity intervention for emergency service workers and their families. Methods: Qualitative interviews were conducted with 6 peer-facilitators. Interviews were audio recorded, transcribed, and analysed using exploratory thematic analysis. Results: Two main themes were explored. The first theme related to the value of lived experience that reflected two subthemes, i) credibility and relatedness by virtue of experience; and ii) knowledge and confidence by virtue of experience. The second theme related to the impact of the peer-facilitator role on the peers themselves, whereby peer-facilitators reported an increased sense of purpose and social connection. Discussion: This qualitative study provides insights into how peer-facilitators can complement health professionals in the delivery of physical activity interventions for emergency service workers. Further research is needed to elucidate training requirements and safety protocols

Engaged advocacy: a framework for inclusion of people from refugee and asylum-seeking backgrounds in disability policy

Engaged advocacy: a framework for inclusion of people from refugee and asylum-seeking backgrounds in disability polic