Is there a link between previous exposure to sport injury psychology education and UK sport injury rehabilitation professionals' attitudes and behaviour towards sport psychology?

Objectives: The use of sport psychology strategies during sport injury rehabilitation can lead to several positive outcomes such as improved adherence and self-efficacy. The purpose of this study was to compare the sport psychology related attitudes and behaviours of UK sport injury rehabilitation professionals (SIRPs) who had studied the psychological aspects of sport injury to those who had not. Participants and design: Ninety-four SIRPs (54 physiotherapists and 40 sports therapists with a mean of 9.22 years' experience of working in sport) completed an online survey and were grouped according to their level of previous exposure to sport injury psychology education at an undergraduate/postgraduate level. Analyses were undertaken to establish whether there were any differences in sport psychology related attitude (MANOVA), usage (MANOVA), and referral behaviours (chi square) between the groups. Results: The MANOVA and chi square tests conducted revealed that those who had studied the psychological aspects of sport injury reported using significantly more sport psychology in their practice and making more referrals to sport psychologists. Conclusions: It was concluded that sport injury psychology education appears to be effective in increasing the sport psychology related behaviours (use of sport psychology and referral) of SIRPs and should be integrated into professional training

The impact of a sport psychology education intervention on physiotherapists

The purpose of this study was to measure the impact of an online sport psychology education module on the attitudes and behaviours of qualified sports physiotherapists in the UK. Ninety-five sport physiotherapists studied either a sport psychology module or a control module, and their attitudes and behaviours towards sport psychology were measured prior to studying the module and at three points over a six-month period following its completion. It was found that those who had studied the sport psychology module demonstrated an improvement in their attitudes towards sport psychology immediately following its completion that was significantly higher than those who had studied the control module. Use of sport psychology also increased following the sport psychology module, with significant differences seen between the intervention and control group on the sport psychology subscale, indicating that those who had studied the sport psychology module were integrating more sport psychology techniques into their practice than those who had studied the control module. It was concluded that the online sport psychology module was effective in improving the attitudes and behaviours of UK physiotherapists and that more sport psychology education opportunities should be made available

Implementation and perceived impact of the SWAN model of end-of-life and bereavement care: a realist evaluation

Objectives To evaluate the End-of-Life and Bereavement Care model (SWAN) from conception to current use. Design A realist evaluation was conducted to understand what works for whom and in what circumstances. The programme theory, derived from a scoping review, comprised: person and family centred care, institutional approaches and infrastructure. Data were collected across three stages (May 2021 to December 2021): semi-structured, online interviews and analysis of routinely collected local and national data. Setting Stage 1: Greater Manchester area of England where the SWAN model was developed and implemented. Stage 2: Midlands. Stage 3: National data. Participants Twenty-three participants were interviewed: Trust SWAN leads, end-of-life care nurses, board members, bereavement services, faith leadership, quality improvement, medicine, nursing, patient transport, mortuary, police and coroners. Results Results from all three stages were integrated within themes, linked to the mechanisms, context and outcomes for the SWAN model. The mechanisms are: SWAN is a values-based model, promoting person/family-centred care and emphasising personhood after death. Key features are: memory-making, normalisation of death and ‘one chance’ to get things right. SWAN is an enablement and empowerment model for all involved. The branding is recognisable and raises the profile of end-of-life and bereavement care. The contextual factors for successful implementation and sustainability include leadership, organisational support, teamwork and integrated working, education and engagement and investment in resources and facilities. The outcomes are perceived to be: a consistent approach to end-of-life and bereavement care; a person/family-centred approach to care; empowered and creative staff; an organisational culture that prioritises end-of-life and bereavement care. Conclusion The SWAN model is agile and has transferred to different settings and circumstances. This realist evaluation revealed the mechanisms of the SWAN model, the contextual factors supporting implementation and perceived outcomes for patients, families, staff and the organisation

Using reef fish movement to inform marine reserve design

A central tenet of protected area design is that conservation areas must be adequate to ensure the persistence of the features that they aim to conserve. These features might include species, populations, communities and/or environmental processes. Protected area adequacy entails both good design (e.g. size, configuration, replication) and management effectiveness (e.g. level of protection, compliance with regulations). With respect to design, guidelines recommend that protected area size be informed by species’ home ranges, as individuals that move beyond protected area boundaries are exposed to threats and are thus only partially protected (Kramer & Chapman 1999). This is especially important for species that are directly exploited, as are many coral reef-associated fishe

Increasing doses of fiber do not influence short-term satiety or food intake and are inconsistently linked to gut hormone levels

Background: People who eat more fiber often have a lower body weight than people who eat less fiber. The mechanism for this relationship has been explained, in part, by increased satiety, which may occur as a result of changes in appetite-suppressing gut hormone levels, and decreases in food intake at subsequent meals. Objective: We hypothesized that increasing doses of mixed fiber, consumed in muffins for breakfast, would proportionally influence satiety, gut hormone levels, and subsequent food intake. Design: This was a randomized, double-blind, crossover study. Healthy men (n=10) and women (n=10) with a BMI of 24±2 (mean±SEM) participated in this study. Fasting subjects consumed a muffin with 0, 4, 8, or 12 g of mixed fibers and approximately 500 kcal. Visual analog scales rated hunger and satiety for 3 h; blood was drawn to measure ghrelin, glucagon-like peptide-1 (GLP-1), and peptide YY3–36 (PYY3–36) at various intervals; and food intake was measured at an ad libitum lunch. Results: Responses to satiety-related questions did not differ among treatments. However, despite lack of differences in satiety, gut hormone levels differed among treatments. Ghrelin was higher after the 12 g fiber dose than after the 4 and 8 g fiber doses. GLP-1 was higher after the 0 g fiber dose than after the 12 and 4 g fiber doses, and PYY3–36 did not differ among fiber doses. Food intake was also indistinguishable among doses. Conclusion: Satiety, gut hormone response, and food intake did not change in a dose-dependent manner after subjects consumed 0, 4, 8, and 12 g of mixed fiber in muffins for breakfast

p53 tumor suppressor gene mutations in fibroblast-like synoviocytes from erosion synovium and non-erosion synovium in rheumatoid arthritis

Abnormalities in the p53 tumor suppressor gene have been detected in rheumatoid arthritis (RA) and could contribute to the pathogenesis of chronic disease. To determine whether synoviocytes from invasive synovium in RA have an increased number of mutations compared with non-erosion synoviocytes, p53 cDNA subclones from fibroblast-like synoviocytes (FLS) derived from erosion and non-erosion sites of the same synovium were examined in patients requiring total joint replacement. Ten erosion FLS lines and nine non-erosion FLS lines were established from nine patients with RA. Exons 5–10 from 209 p53 subclones were sequenced (114 from erosion FLS, 95 from non-erosion FLS). Sixty percent of RA FLS cell lines and 8.6% of the p53 subclones isolated from FLS contained p53 mutations. No significant differences were observed between the erosion and non-erosion FLS with regard to the frequency or type of p53 mutation. The majority of the mutations were missense transition mutations, which are characteristic of oxidative damage. In addition, paired intact RA synovium and cultured FLS from the same joints were evaluated for p53 mutations. Matched synovium and cultured synoviocytes contained p53 mutations, although there was no overlap in the specific mutations identified in the paired samples. Clusters of p53 mutations in subclones were detected in some FLS, including one in codon 249, which is a well-recognized 'hot spot' associated with cancer. Our data are consistent with the hypothesis that p53 mutations are randomly induced by genotoxic exposure in small numbers of RA synoviocytes localized to erosion and non-erosion regions of RA synovium. The determining factor for invasiveness might be proximity to bone or cartilage rather than the presence of a p53 mutation

Association of ten gastrointestinal and other medical conditions with positivity to faecal occult blood testing in routine screening:a large prospective study of women in England

Background: In 2006, the Bowel Cancer Screening Programme (BCSP) in England began offering biennial faecal occult blood testing (FOBt) at ages 60-69 years. Although FOBt is aimed at detecting colorectal neoplasms, other conditions can affect the result. In a large UK prospective study, we examined associations, both before and after screening, between FOBt-positivity and 10 conditions that are often associated with gastrointestinal bleeding. Methods: By electronically linking BCSP and Million Women Study records, we identified 604,495 women without prior colorectal cancer who participated in their first routine FOBt screening between 2006 and 2012. Regression models, using linked national hospital admission records, yielded adjusted relative risks (RRs) in FOBt-positive versus FOBt-negative women for colorectal cancer, adenoma, diverticular disease, inflammatory bowel disease, haemorrhoids, upper gastrointestinal cancer, oesophagitis, peptic ulcer, anaemia and other haematological disorders. Findings: RRs in FOBt-positive versus FOBt-negative women were 201.3 for colorectal cancer and 197.9 for adenoma within 12 months after screening and 3.5 and 4.9, respectively, 12-24 months after screening; pand#60;0.001 for all RRs. Within 12 months after screening, the RR for inflammatory bowel disease was 26.3, and ranged from 2 to 5 for upper gastrointestinal or haematological disorders. The RRs of being diagnosed with any of the 8 conditions other than colorectal neoplasms before screening and in the 12-24 months after screening, were 1.81 and 1.92, respectively. Conclusions: While fOBt-positivity is associated with a substantially increased risk of colorectal neoplasms after screening, eight other gastrointestinal and haematological conditions are associated with FOBt-positivity, both before and after screening

Novel enrichment reduces boredom-associated behaviours in housed dairy cows

There is currently societal interest and concern for dairy cow welfare. It has been suggested that boredom poses a welfare issue for dairy cows, particularly when presented with extended disposable time in housed environments that lack stimuli. Farm animals experience a multitude of affective states, which has created a need for positive experiences to be included in welfare management. Environmental enrichment can reduce boredom and facilitate positive experiences however the research in cows is limited. To assess the behavioral impact of a simple enrichment on commercially housed dairy cows, we provided 24-h access to a novel object, for 3 weeks, for 2 separate groups of cows. Two boredom-associated behaviors significantly decreased when the object was present compared with when it was not present: ‘idling' behavior and unsuccessful robotic milking attempts ‘refusals'. In addition, there was a significant increase in the occurrence of self-grooming during treatment weeks, when the novel object was present. These results suggest that idling and refusals may be behavioral indicators of boredom in dairy cows

Is group cognitive behaviour therapy for postnatal depression evidence-based practice? A systematic review

Background: There is evidence that psychological therapies including cognitive behaviour therapy (CBT) may be effective in reducing postnatal depression (PND) when offered to individuals. In clinical practice, this is also implemented in a group therapy format, which, although not recommended in guidelines, is seen as a cost-effective alternative. To consider the extent to which group methods can be seen as evidence-based, we systematically review and synthesise the evidence for the efficacy of group CBT compared to currently used packages of care for women with PND, and we discuss further factors which may contribute to clinician confidence in implementing an intervention. Methods: Seventeen electronic databases were searched. All full papers were read by two reviewers and a third reviewer was consulted in the event of a disagreement on inclusion. Selected studies were quality assessed, using the Cochrane Risk of Bias Tool, were data extracted by two reviewers using a standardised data extraction form and statistically synthesised where appropriate using the fixed-effect inverse-variance method. Results: Seven studies met the inclusion criteria. Meta-analyses showed group CBT to be effective in reducing depression compared to routine primary care, usual care or waiting list groups. A pooled effect size of d = 0.57 (95% CI 0.34 to 0.80, p < 0.001) was observed at 10–13 weeks post-randomisation, reducing to d = 0.28 (95% CI 0.03 to 0.53, p = 0.025) at 6 months. The non-randomised comparisons against waiting list controls at 10–13 weeks was associated with a larger effect size of d = 0.94 (95% CI 0.42 to 1.47, p < 0.001). However due to the limitations of the available data, such as ill-specified definitions of the CBT component of the group programmes, these results should be interpreted with caution. Conclusions: Although the evidence available is limited, group CBT was shown to be effective. We argue, therefore, that there is sufficient evidence to implement group CBT, conditional upon routinely collected outcomes being benchmarked against those obtained in trials of individual CBT, and with other important factors such as patient preference, clinical experience, and information from the local context taken into account when making the treatment decision