Can clinicians and scientists explain and prevent unexplained underperformance syndrome in elite athletes: an interdisciplinary perspective and 2016 update

The coach and interdisciplinary sports science and medicine team strive to continually progress the athlete's performance year on year. In structuring training programmes, coaches and scientists plan distinct periods of progressive overload coupled with recovery for anticipated performances to be delivered on fixed dates of competition in the calendar year. Peaking at major championships is a challenge, and training capacity highly individualised, with fine margins between the training dose necessary for adaptation and that which elicits maladaptation at the elite level. As such, optimising adaptation is key to effective preparation. Notably, however, many factors (eg, health, nutrition, sleep, training experience, psychosocial factors) play an essential part in moderating the processes of adaptation to exercise and environmental stressors, for example, heat, altitude; processes which can often fail or be limited. In the UK, the term unexplained underperformance syndrome (UUPS) has been adopted, in contrast to the more commonly referenced term overtraining syndrome, to describe a significant episode of underperformance with persistent fatigue, that is, maladaptation. This construct, UUPS, reflects the complexity of the syndrome, the multifactorial aetiology, and that ‘overtraining’ or an imbalance between training load and recovery may not be the primary cause for underperformance. UUPS draws on the distinction that a decline in performance represents the universal feature. In our review, we provide a practitioner-focused perspective, proposing that causative factors can be identified and UUPS explained, through an interdisciplinary approach (ie, medicine, nutrition, physiology, psychology) to sports science and medicine delivery, monitoring, and data interpretation and analysis

Phenotypic sexual dimorphism is associated with genomic signatures of resolved sexual conflict

Intra‐locus sexual conflict, where an allele benefits one sex at the expense of the other, has an important role in shaping genetic diversity of populations through balancing selection. However, the potential for mating systems to exert balancing selection through sexual conflict on the genome remains unclear. Furthermore, the nature and potential for resolution of sexual conflict across the genome has been hotly debated. To address this, we analysed de novo transcriptomes from six avian species, chosen to reflect the full range of sexual dimorphism and mating systems. Our analyses combine expression and population genomic statistics across reproductive and somatic tissue, with measures of sperm competition and promiscuity. Our results reveal that balancing selection is weakest in the gonad, consistent with the resolution of sexual conflict and evolutionary theory that phenotypic sex differences are associated with lower levels of ongoing conflict. We also demonstrate a clear link between variation in sexual conflict and levels of genetic variation across phylogenetic space in a comparative framework. Our observations suggest that this conflict is short‐lived, and is resolved via the decoupling of male and female gene expression patterns, with important implications for the role of sexual selection in adaptive potential and role of dimorphism in facilitating sex‐specific fitness optima

Economic evaluations in paediatric dentistry clinical trials

Economic evaluations play an important role in identifying the cost‐effectiveness of alternative healthcare programmes, informing decisions surrounding funding and the allocation of resources. This paper outlines the basic principles of economic evaluation and how it can be conducted alongside a clinical trial. Furthermore, it considers the ways in which evidence from these studies can be used, and the challenges researchers are faced with when conducting economic evaluations in the field of children’s oral health

Motivation as a predictor of outcomes in school-based humanistic counselling

Recent years have seen a growth in the provision of counselling within UK secondary schools, and research indicates that it is associated with significant reductions in psychological distress. However, little is known about the moderators and mediators of positive therapeutic benefit. In the field of adult mental health, motivation has been found to be one of the strongest predictors of therapeutic outcomes, and it was hypothesised that this may also be a predictor of outcomes for young people in school-based counselling services. To assess the relationship between young people’s motivation for counselling and its effectiveness within a secondary school setting. Eighty-one young people (12 - 17 years old) who attended school-based humanistic counselling services in Scotland. Clients completed a measure of motivation for counselling at the commencement of their therapeutic work and a measure of psychological wellbeing at the commencement and termination of counselling. Motivation for counselling was not found to be significantly related to outcomes. The results indicate that the association between motivation and outcomes may be weaker in young people as compared with adults. However, a number of design factors may also account for the non-significant findings: insufficient participants, marginal reliability of the motivation measure and social desirability effects

Supersymmetric solutions of PT-/non-PT-symmetric and non-Hermitian Screened Coulomb potential via Hamiltonian hierarchy inspired variational method

The supersymmetric solutions of PT-symmetric and Hermitian/non-Hermitian forms of quantum systems are obtained by solving the Schrodinger equation for the Exponential-Cosine Screened Coulomb potential. The Hamiltonian hierarchy inspired variational method is used to obtain the approximate energy eigenvalues and corresponding wave functions.Comment: 13 page

ASTEC -- the Aarhus STellar Evolution Code

The Aarhus code is the result of a long development, starting in 1974, and still ongoing. A novel feature is the integration of the computation of adiabatic oscillations for specified models as part of the code. It offers substantial flexibility in terms of microphysics and has been carefully tested for the computation of solar models. However, considerable development is still required in the treatment of nuclear reactions, diffusion and convective mixing.Comment: Astrophys. Space Sci, in the pres

The palliative care needs and experiences of people with advanced head and neck cancer: a scoping review

Background: The palliative care needs of people with advanced head and neck cancer pose unique complexities due to the impact the illness has on eating, speaking, appearance and breathing. Examining these needs would help provide guidance about developing relevant models of care and identify gaps in research knowledge. Aim: To identify and map out the palliative care needs and experiences for people with advanced head and neck cancer. Design: A scoping literature review following the methods described by the Joanna Briggs Institute. Data sources: An electronic search of the literature was undertaken in MEDLINE (Ovid), EMBASE and CINAHL covering the years January 1996 to January 2019. Results: People with advanced head and neck cancer often had palliative care needs but there was variability in the timing and access to relevant services. A high prevalence of interventions, for example hospital admissions were needed even during the last month of life. This was not necessarily negated with early engagement of palliative care. Dissonance between patients and family carers about information needs and decision-making was an additional complexity. Studies tended to be descriptive in nature, and often involved a single centre. Conclusion: This scoping review demonstrates the complexity of care for people with advanced head and neck cancer and the issues related to the current healthcare systems. Focus on appropriate referral criteria, increased integration and coordination of care and robust evaluation of specific care components seems key. Linkage between research and service design delivery across teams, disciplines and care settings seems pertinent

An Opinion Dynamics Model for the Diffusion of Innovations

We study the dynamics of the adoption of new products by agents with continuous opinions and discrete actions (CODA). The model is such that the refusal in adopting a new idea or product is increasingly weighted by neighbor agents as evidence against the product. Under these rules, we study the distribution of adoption times and the final proportion of adopters in the population. We compare the cases where initial adopters are clustered to the case where they are randomly scattered around the social network and investigate small world effects on the final proportion of adopters. The model predicts a fat tailed distribution for late adopters which is verified by empirical data.Comment: 14 pages, 8 figures, revised text, a new section with empirical evidence has been adde

Cognitive Social Psychology

Social psychology is presently dominated by cognitive theories that emphasize the importance of personal beliefs and in tellective processes as the immediate determinants of behavior. The present paper explores two areas of.research within this tra dition : (1) beliefs about the external world, and (2) beliefs about the self. The paper concludes with a brief critique of the cognitive approach to social psychology.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/69030/2/10.1177_014616727700300402.pd

Developing the digital self-determined learner through heutagogical design

This empirical qualitative study investigates whether the introduction of heutagogy in contemporary nursing education can foster the development of the digital self-determined learner, who is prepared to work and live in the fourth industrial age and beyond. The impact of heutagogical design on learner process and outcomes is explored through qualitative framework analysis of learner data and reflective educator observations. Findings suggest that with careful scaffolding and courage in remaining true to the educational philosophy, this approach has the potential to develop learners who demonstrate key principles of heutagogy including non-linear learning, learner agency, capability, self-reflection and metacognition and double-loop learning. This innovative study provides insight into the process of developing the self-determined learner and encourages further research into flexible and learner-centred approaches across Higher Education