The Effects of Acute Anaerobic Exercise on the Cardiovascular and Metabolic Response to the Cold Pressor Test in Healthy Adult Males

International Journal of Exercise Science 13(3): 1729-1740, 2020. Little is known about the physiological response to the cold pressor test (CPT) when in a clinically-induced state of autonomic nervous system (ANS) imbalance, despite its utility in various disease- and injury-states. To date, research in this area is limited to acute aerobic and isometric exercise, with a paucity of research investigating the effects of anaerobic exercise on the physiological response to the CPT. Therefore, the purpose of our study was to assess the effects of the Wingate anaerobic cycle test (WAT) on cardiovascular (CV) and metabolic recovery following the CPT in a group of healthy adult males. A pre-post intervention study was conducted, whereby 10 healthy adult males (age = 29 ± 4 years, height = 182 ± 7 cm, mass = 83 ± 9 kg) completed a baseline cold pressor test (CPT-only) and a follow-up cold pressor test preceded by a Wingate anaerobic exercise test (WAT+CPT). Recovery slopes for various CV and metabolic variables, including heart rate (HR), blood pressure (BP), and relative oxygen consumption (O2) were analyzed using single-subject analysis, with celeration line slopes calculated for all participants in the CPT-only and WAT+CPT testing sessions. Celeration line slopes were compared between testing sessions using paired t-tests. No differences were identified for recovery slopes for HR (p = .295), diastolic BP (p = .300), and relative O2 (p= .176) when comparing CPT-only and WAT+CPT testing sessions. Our results suggest that the CPT elicits a CV and metabolic response beyond that elicited solely by an acute bout of anaerobic exercise. As such, the CPT may be able to serve as a surrogate test for anaerobic exercise for individuals where high-intensity exercise may be contraindicated. Future research is warranted however, as the specific physiological mechanisms governing the observed responses have yet to be elucidated

The relationship between psychological distress and multiple tender points across the adult lifespan

Multiple tender points are common in the population and, in studies of mid-life adults, are strongly associated with high levels of psychological distress. Whether this relationship occurs in older adults is unclear. This cross-sectional study investigated whether high levels of psychological distress would be associated with a high tender point count and whether the relationship would be moderated by age. Three thousand three hundred and seventy-nine individuals were mailed a questionnaire which included the Hospital Anxiety and Depression (HAD) scale, the Pain Catastrophising Scale (PCS), the Brief Illness Perception Questionnaire (Brief IPQ), and the Pittsburgh Sleep Quality Index (PSQI). A random sample of approximately 10% of subjects who returned the questionnaire undertook a physical assessment, including a manual tender point count assessment.A total of 2385 (71%) subjects completed the questionnaire, of whom 798 (33%) were invited to take part in the physical assessment and 290 (12%) participated. Of the 290 participants the median age was 64 years (range 34-97) and 63% were female. The median HAD score was 9 (IQR 5-14) and the median number of tender points was 3 (range 0-7).Increasing HAD score was positively and significantly associated with tender point count, but this relationship was not moderated by age. In a final multivariable model, sex, HAD score and PSQI score were independent predictors of multiple tender points.Psychological distress was associated with multiple tender points independent of age. Psychological distress and trouble sleeping were important, potentially modifiable factors associated with the outcome

“That’s what makes me better”: Investigating children and adolescents’ experiences of pain communication with healthcare professionals in paediatric rheumatology

BackgroundPain communication should be an integral part of clinical consultations, particularly in paediatric rheumatology where children and adolescents frequently present with chronic musculoskeletal pain. To date, literature exploring the nature of and extent to which pain communication occurs has focused on healthcare professionals as respondents, yielding inconsistent and incomplete findings. The aim of this study was to explore children and adolescents’ experiences of pain communication in the context of paediatric rheumatology consultations. MethodsData were collected using semi-structured telephone interviews with children and adolescents recruited from three tertiary paediatric rheumatology centres in the UK. A framework analysis approach was used to explore the similarities and divergences in participant accounts. ResultsTwenty-six children and adolescents (aged 6-18 years, median=14, 58% female) participated. Diagnoses included: Juvenile Idiopathic Arthritis, Chronic Idiopathic Pain Syndromes, Ehlers Danlos Syndrome/Hypermobility. Four themes were identified: 1) Co-ordination of pain communication; 2) Barriers to pain communication; 3) Facilitators of pain communication; 4) Dissatisfaction with pain communication. These themes particularly encompassed the process of communication, disclosure of effective and ineffective approaches and the impact of communication. Participants expected questions about pain, felt cared about and found talking about pain natural. Challenges included augmenting the feeling of being different to peers and concerns about management plans changing as a result of pain conversations. ConclusionsChildren and adolescents recalled a range of effective and ineffective pain communication approaches. Our study informs recommendations which highlight how paediatric healthcare professionals can improve their communication about pain with children and adolescents in the future. <br/

Emergences and affordances as opportunities to develop teachers’ mathematical content knowledge

Teachers’ mathematical content knowledge has been under scrutiny for some time. This development is in the wake of learners’ unsatisfactory performance in national examinations and international achievement tests. A widely held belief is that one, if not the most important, of the efforts to improve and enhance the performance and achievement in mathematics of learners is addressing teachers’ mathematical content and pedagogical content knowledge through continuous professional development initiatives. The focus of this article is on the former. It describes how emergent and affording opportunities are brought to the fore from classroom observations and interactions in workshops and institutes with practising teachers. It concludes that this in situ dealing with mathematical content knowledge holds much promise for buy-in by teachers because it addresses an immediate need related to their practice

'New to me': changing patient understanding of psoriasis and identifying mechanisms of change. The Pso Well® patient materials mixed-methods feasibility study

BACKGROUND: Psoriasis is an inflammatory long-term condition involving comorbidities, unhealthy lifestyle and significant life impact. Patients' understanding of psoriasis is limited and support lacking. The Common-Sense Model of Self-Regulation of Health and Illness emphasizes the role of illness and treatment beliefs on coping and self-management. New 'Pso Well® ' patient materials informed by the model, addressed psoriasis as a long-term condition, medication management and lifestyle behaviours. OBJECTIVES: To investigate whether Pso Well® materials (i) broaden understanding of psoriasis without increasing anxiety; (ii) are acceptable; and (iii) comprise features that appear to effect change. METHODS: The Revised Illness Perceptions Questionnaire (IPQ-R modified) and the Hospital Anxiety and Depression Scale (HADS) were administered in patients before and after intervention. Numerical rating scales assessed perceptions of change in understanding and anxiety resulting from engagement with the materials. Qualitative interviews explored acceptability and perceived 'active ingredients'. RESULTS: Fifty-five patients completed pre- and postintervention questionnaires (56% female; median age 59 years). Postintervention, a large effect size was indicated in two IPQ-R domains - illness coherence [t(55) = -3·48, P = 0·001 (two-tailed), η2  = 0·19] and personal control [t(55) = -2·98, P = 0·004 (two-tailed), η2  = 0·14] - and a medium effect in one, treatment control [t(55) = -2·08, P = 0·042 (two-tailed), η2  = 0·08]. HADS scores did not change. For numerical rating scales, 80% of participants reported increased understanding of psoriasis and none reported increased anxiety. Interviews with 19 patients indicated the materials were acceptable and usable. Factors reported to broaden understanding and promote engagement with self-management included linking of related disease aspects, personally relevant content and high-quality design. CONCLUSIONS: High-quality, theory-based psoriasis materials are acceptable to patients and can improve understanding and sense of control without increasing anxiety

Evidence-Based Professional Development of Science Teachers in Two Countries

The focus of this collaborative research project of King?s College London, and the Weizmann Institute, Israel. project is on investigating the ways in which teachers can demonstrate accomplished teaching in a specific domain of science and on the teacher learning that is generated through continuing professional development programs (CPD) that lead towards such practice. The interest lies in what processes and inputs are required to help secondary school science teachers develop expertise in a specific aspect of science teaching. `It focuses on the design of the CPD programmes and examines the importance of an evidence-based approach through portfolioconstruction in which professional dialogue pathes the way for teacher learning. The set of papers highlight the need to set professional challenge while tailoring CPD to teachers? needs to create the environment in which teachers can advance and transform their practice. The cross-culture perspective added to the richness of the development and enabled the researchers to examine which aspects were fundamental to the design by considering similarities and differences between the domains

Data protection, information governance and the potential erosion of ethnographic methods in health care?

From Wiley via Jisc Publications RouterHistory: received 2021-05-19, rev-recd 2021-10-27, accepted 2021-11-02, pub-electronic 2021-11-23Article version: VoRPublication status: PublishedFunder: Versus Arthritis; Grant(s): 22433, 20380Funder: National Institute of Health ResearchFunder: Applied Research CollaborationFunder: North East and North CumbriaAbstract: With the most recent developments to the European General Data Protection Regulations (GDPR) introduced in May 2018, the resulting legislation meant a new set of considerations for study approvers and health‐care researchers. Compared with previous legislation in the UK (The Data Protection Act, 1998), it introduced more extensive and directive principles, requiring anybody ‘processing’ personal data to specifically define how this data will be obtained, stored, used and destroyed. Importantly, it also emphasised the principle of accountability, which meant that data controllers and processors could no longer just state that they planned to adhere to lawful data protection principles, they also had to demonstrate compliance. New questions and concerns around accountability now appear to have increased levels of scrutiny in all areas of information governance (IG), especially with regards to processing confidential patient information. This article explores our experiences of gaining required ethical and regulatory approvals for an ethnographic study in a UK health‐care setting, the implications that the common law duty of confidentiality had for this research, and the ways in which IG challenges were overcome. The purpose of this article was to equip researchers embarking on similar projects to be able to navigate the potentially problematic and complex journey to approval

Empirical evidence of the impact of lesson study on: students’ achievement, teachers’ professional learning and on institutional and system evolution

In this article we review the evidence of the impact of lesson study on student learning, teacher development, teaching materials, curriculum, professional learning and system enhancement. We argue for lesson study to be treated holistically as a vehicle for development and improvement at classroom, school and system levels rather than as a curricular or pedagogical intervention. We illustrate the need for this approach to evaluating lesson study through a complex case exemplar which used Research Lesson Study (a form of lesson study popular in the UK and Europe) to develop learning, teaching, curriculum and local improvement capacity across schools initially involved in a two-year mathematics curriculum development project that later evolved into three self-sustaining, voluntary lesson study school hubs in London. We discuss resulting changes in culture, practice, belief, expectation and student learning. We argue as a result for greater policy level understanding of this expanded conception of lesson study as a vehicle in classroom, school and system transformation.Both projects described received funding from the Greater London Authorit